Non-Hodgkin’s lymphoma is most often treated with anti-cancer drugs, called chemotherapy. It may be used in combination with radiation therapy. For B-cell lymphomas, chemotherapy is often combined with targeted therapy using the antibody rituximab (Rituxan), which attacks B-cell lymphocytes.
Seattle Cancer Care Alliance (SCCA) researchers are studying new mixtures of chemotherapy drugs to find the most effective combinations for different types of the disease. Many of our patients receive these combinations by taking part in clinical studies, also called clinical trials.
What Chemotherapy Does
Chemotherapy is systemic; the drugs enter your bloodstream and go throughout your body. Chemotherapy can help kill cancer cells that are in the lymph system as well as those that may have spread to other areas. Chemotherapy works by killing fast-growing cells, but the drugs cannot discriminate between cancer cells and other fast-growing cells, which may lead to side effects like hair loss.
Getting Chemotherapy for Non-Hodgkin’s Lymphoma
These medicines are usually given through an intravenous (IV) line into a vein in the hand or arm or through a port into a vein in the chest. Some forms may be taken by mouth in pill form. If you’re coming in for chemotherapy infusions, you may want to bring a friend or family member to sit with you during treatment, which sometimes takes several hours.
Chemotherapy for non-Hodgkin’s lymphoma is given in cycles, which means you receive an infusion of your chemotherapy drugs by IV on one day, and then you wait three to four weeks before receiving your next dose. This gives the drugs time to have an effect and also gives your body some time to recover before getting more. The number of cycles you receive depends mainly on the drugs you need and the stage of your cancer.
For non-Hodgkin’s lymphoma, a common chemotherapy regimen we use is called CHOP:
- Cyclophosphamide (Cytoxan, Clafen, Neosar)
- Doxorubicin hydrochloride (Adriamycin)
- Vincristine (Oncovin, Vincasar, Vincrex)
Doctors at SCCA also use other chemotherapy regimens, including EPOCH—etoposide (Toposar, VePesid), prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride. For relapsed NHL, the primary chemotherapy is referred to as ICE—ifosfamide (Cyfos, Ifex, Ifosfamidum), carboplatin (Paraplat, Paraplatin), and etoposide. If chemotherapy is combined with the antibody rituximab (Rituxan), the regimen name includes the letter R, such as R-CHOP.
Your doctor will recommend the combination most likely to work for your cancer.
Side effects of chemotherapy vary greatly from person to person and depend on the type and dose of the drugs given, the way they are given, and the length of time they are given. Your treatment team can tell you about the side effects that are most common with your drugs. Let your team know about any side effects you experience.
For general information to help you cope with side effects, visit our section on symptom management.