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Non-Hodgkin lymphoma

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Treatment of advanced stage indolent non-Hodgkin lymphoma

The following are treatment options for advanced stage indolent non-Hodgkin lymphoma (NHL). The types of treatments given are based on the unique needs of the person with lymphoma. Indolent lymphomas tend to be widespread, so most people have advanced stage disease when they are first diagnosed.

Indolent NHLs are often quite sensitive to treatment initially and even an advanced indolent lymphoma can often be controlled for many years.

Watchful waiting

Watchful waiting may be offered to some people with advanced stage indolent NHL who do not have symptoms. An indolent lymphoma may not need to be treated right away because these lymphomas grow slowly and there may be long periods of time where there is no change in the disease. Early treatment has not shown to improve survival in this subset of lymphomas. People are usually treated only when symptoms appear or the lymphoma progresses.


Chemotherapy is used for advanced stage indolent lymphoma that is causing symptoms or seems to be progressing. The types of chemotherapy treatment are:

  • single drugs
    • chlorambucil (Leukeran)
    • fludarabine (Fludara)
    • cyclophosphamide (Cytoxan, Procytox)
  • a combination of chemotherapy drugs
    • CVP – cyclophosphamide, vincristine (Oncovin) and prednisone (Deltasone) – is most commonly used in people who need chemotherapy treatment. It is often given in combination with biological therapy

Radiation therapy

External beam radiation therapy may also be given to specific areas to control symptoms of advanced stage indolent NHL.

Biological therapy

Biological therapy may be offered for some advanced stage indolent NHLs. Rituximab (Rituxan) is the biological therapy used most often. It is only used for B-cell lymphomas. It may be given alone, but is most often used in combination with chemotherapy.

Clinical trials

People with advanced stage indolent NHL may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.


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