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Non-Hodgkin lymphoma treatments

The primary treatments for non-Hodgkin lymphoma include chemotherapy, radiation therapy, stem cell transplantation and targeted therapy. Immunotherapy has also emerged as a potential treatment for certain types of non-Hodgkin lymphoma. At Cancer Treatment Centers of America® (CTCA), your multidisciplinary team of oncologists and supportive care clinicians will work with you to develop a treatment plan tailored to your diagnosis and needs.

Treatments for non-Hodgkin lymphoma

Non-Hodgkin lymphoma is a complex disease with many types and sub-types, which  may develop in either B-cells or T-cells. Some varieties of the disease may be aggressive or indolent (slow-growing).

Choosing a treatment plan for non-Hodgkin lymphoma often depends on the type and stage of the disease, as well as the patient’s overall health, personal needs and goals. An accurate diagnosis is critical to helping to determine treatment options tailored to each individual.

Treatments for B-cell lymphoma

Almost 90 percent of all non-Hodgkin lymphoma cases originate in B-cells. There are many types and sub-types of B-cell lymphoma, but the most common include:

  • Diffuse large B-cell lymphoma
  • Follicular lymphoma
  • Mantle cell lymphoma
  • Marginal zone lymphoma

Treatments for B-cell lymphomas include:

Chemotherapy

Chemotherapy may be used to treat all types of non-Hodgkin lymphoma, including aggressive and non-aggressive forms, and may also be used to help prevent the disease from recurring. Chemotherapy for non-Hodgkin lymphoma often consists of giving several drugs together in a set regimen. A common form used specifically to treat diffuse large B-cell lymphoma is CHOP chemotherapy, which is a combination of four chemotherapy drugs.

Depending on the drug, regimen and personal preferences, chemotherapy drugs may be administered:

  • Orally, in liquid or pill form taken by mouth
  • By infusion, delivered into a vein through an intravenous drip
  • By injection, delivered into a vein, muscle or under the skin

Learn more about chemotherapy

Immunotherapy

Several types of immunotherapy drugs are used to treat non-Hodgkin lymphoma. Some immunotherapies, called immunomodulating drugs, affect parts of the immune system, although how they work isn’t clear. Immunomodulating drugs are sometimes used to treat certain types of lymphoma after other treatments have failed. Another treatment, called chimeric antigen receptor, or CAR T-cell therapy, works by altering a patient’s T-cells to add receptors that seek out and attack lymphoma cells.

Learn more about CAR T-cell therapy

Radiation therapy

Radiation therapy for non-Hodgkin lymphoma may be used to destroy lymphoma cells or to prevent the cells from growing and reproducing. It may also be used to relieve pain or discomfort caused by an enlarged spleen or swollen lymph nodes. For patients with non-Hodgkin lymphoma, radiation is generally confined to the lymph nodes and the areas surrounding the lymph nodes.

Depending on your individual needs, we may combine radiation treatment with other therapies, such as targeted therapy and chemotherapy, to prevent the growth of new cancer cells.

Learn more about radiation therapy

Stem cell transplantation

Before a stem cell transplant for non-Hodgkin lymphoma, you will undergo a conditioning regimen that involves intensive treatment, such as high-dose chemotherapy, to destroy as many cancer cells as possible. Following this, you will receive the stem cells intravenously (similar to a blood transfusion). After entering the bloodstream, the stem cells travel to the bone marrow and begin to produce healthy new blood cells in a process known as engraftment.

Sometimes, the high doses of chemotherapy or radiation you receive before the stem cell transplant cause side effects, such as infection. An allogeneic stem cell transplant (using cells from a donor) poses the risk of graft-versus-host disease (GVHD), a condition where the donated cells attack the patient’s tissues. Your doctor may prescribe certain drugs to reduce the risk of infection or GVHD.

Learn more about hematologic oncology

Targeted therapy

Monoclonal antibody therapy is a type of targeted therapy that uses immune cells engineered in a laboratory. These cells, when injected back into the body, are designed to target specific features in cells, killing them or preventing them from growing.

Monoclonal antibodies may be used alone to target lymphoma cells, or in combination with chemotherapy or radiation therapy drugs.

Learn more about precision medicine

Treatments for T-cell lymphoma

T-cell non-Hodgkin lymphoma types are rarer than B-cell varieties, but some may be very aggressive. Types of T-cell lymphoma include:

  • Natural killer cell lymphoma
  • Peripheral T-cell lymphoma
  • Sezary syndrome
  • Mycosis fungoides

Treatments for T-cell lymphomas include:

  • Chemotherapy
  • Targeted therapy
  • Radiation therapy
  • Stem cell transplantation

Learn more about T-cell lymphoma types

Treatment for AIDS-associated lymphoma

Patients with human immunodeficiency virus (HIV) may be at a higher risk of developing cancer, especially lymphoma. HIV weakens the immune system, making it more difficult to fight off disease, infections and conditions such as acquired immune deficiency syndrome (AIDS).

AIDS-associated lymphoma most often develops in the lymph system, the body’s network of organs, nodes and vessels that help fight infection. Diffuse large B-cell lymphoma and Burkitt lymphoma are among the most common types of non-Hodgkin lymphoma in patients with AIDS. Lymphoma is a leading cause of death among patients with HIV.

These patients are also at a higher risk of developing Hodgkin lymphoma and Kaposi sarcoma, a rare form of skin cancer.

Treatment options for patients with AIDS-associated lymphoma depend on the overall health of the patient and the type of lymphoma diagnosed.

What’s the difference: Hodgkin lymphoma and non-Hodgkin lymphoma

Active surveillance for non-Hodgkin lymphoma

Some patients diagnosed with an indolent, or slow-growing, type of non-Hodgkin lymphoma who are not experiencing symptoms, may not require immediate treatment. These patients are typically put on active surveillance, a program in which their condition is monitored, but not treated.

During active surveillance, sometimes referred to as watchful waiting, patients may receive regular laboratory tests, physical exams and imaging tests such as CT scans or X-rays. Treatment may begin only when symptoms develop or tests indicate the lymphoma is progressing. 

Non-Hodgkin lymphoma clinical trials

With a new generation of drugs and treatments in development for non-Hodgkin lymphoma, clinical trials are a critical testing ground for determining their effectiveness and safety. As part of our commitment to providing new and innovative treatments, our doctors may recommend that you enroll in a clinical trial that may offer you access to treatment options for non-Hodgkin lymphoma that would otherwise be unavailable to you.

Each patient is considered for a clinical trial on an individual basis and must meet strict and specific criteria. Patients may qualify at any stage of their disease or treatment. Talk to your doctor about whether a clinical trial is an option for you and ask about the risks and requirements involved.

Search clinical trials

Side effect management

At CTCA®, our lymphoma cancer experts work closely with our integrative care team to anticipate and address potential side effects so you can better tolerate treatments. Integrative care services designed to help manage non-Hodgkin lymphoma-related side effects include: 

Learn more about integrative care

"I called CTCA right away and made an appointment. Within the next week, I was diagnosed with non-Hodgkin lymphoma, staged, given my treatment options and assured that I was not alone in my fight. I was on a team now—which I was to be a big part of—and we were going to do everything possible to beat this disease."

Robbie Robinson

Robbie R.

Non-Hodgkin Lymphoma

MORE ABOUT ROBBIE

More About ROBBIE