blood disorders
Non Hodgkin Lymphomas
Treatment of Non Hodgkin Lymphomas
Chemotherapy, radiation therapy, or both Immunotherapy (drugs made up of antibodies that attack cancer cells), with or without chemotherapy Sometimes stem cell transplantation The treatment of non-Hodgkin lymphoma varies widely based on the subtype. For some people with indolent lymphomas, treatment is not needed when the lymphoma is first diagnosed. Studies show that waiting does not compromise outcome and prevents the patient from being exposed to side effects of treatment earlier than necessary. For people with indolent lymphomas, treatment, when needed, extends life and relieves symptoms for many years. For people with aggressive lymphomas, cure is possible and therefore waiting without treatment is not usually done. The likelihood of a cure or long-term survival depends on the type of non-Hodgkin lymphoma and the stage when treatment starts. It is somewhat of a paradox that indolent lymphomas usually respond readily to treatment by going into remission (in which the disease is under control), often followed by long-term survival, but the disease usually is not cured. In contrast, aggressive non-Hodgkin lymphomas, which usually require very intensive treatment to achieve remission, have a good chance of being cured. People with indolent lymphomas who have very limited disease (stage I) are often treated with Radiation Therapy for Cancer limited to the site of the lymphoma and adjacent areas. With this approach, most people do not have a disease recurrence in the irradiated area, but non-Hodgkin lymphomas can recur elsewhere in the body as long as 10 years after treatment, so people require long-term monitoring. People with aggressive lymphomas at a very early stage need to be treated with combination chemotherapy and sometimes radiation therapy. Stage II non-Hodgkin lymphoma usually behaves like limited disease (stage I) but sometimes behaves like advanced disease. Doctors choose the treatment depending on the disease behavior. Almost all people withindolent lymphomashave stage II to IV disease. They do not always require treatment initially, but they are monitored for evidence of lymphoma progression, which could signal a need for therapy, sometimes years after the initial diagnosis. There is no evidence that early treatment extends survival in people with indolent lymphomas at more advanced stages. If the disease begins to progress, there are many treatment choices. ) alone or combined with Chemotherapy and Other Systemic Cancer Treatments . Most treatments are given intravenously. Sometimes, oral drugs are used. Treatment usually produces a remission. The average length of remission depends on the intensity of the treatment. Sometimes treatment may also include maintenance therapy (therapy given after the initial treatment to help prevent relapse). , stage II to IV, Combination Cancer Therapy drugs are given promptly, often together with Combinations of chemotherapy drugs are often named by combining the initial letter of each drug name. After radiation therapy, there is an increased risk of secondary cancers occurring 10 or more years after treatment in organs that were in the radiation field. Overview of Leukemia may develop in some people many years after successful treatment for non-Hodgkin lymphoma, regardless of the treatment used. After treatment has been finished, people should have regular doctor's examinations and tests to look for return of the lymphoma (post-treatment surveillance). The type of tests depends on the patient's risk factors and type of treatment they received. Most people who have a relapse of an aggressive lymphoma receive high doses of chemotherapy drugs combined with autologous Stem Cell Transplantation , involving the person's own stem cells. With this type of treatment, some people are cured. Sometimes stem cells from a sibling or even an unrelated donor (allogeneic transplant) can be used, but this type of transplantation has a greater risk of complications. Sometimes people are offered treatment with chimeric antigen receptor (CAR) T cells, which are T cells that have been genetically engineered to fight against lymphoma. 