How is the course of treatment decided?:
Aggressive Non-Hodgkin Lymphoma can be treated with chemotherapy, radiotherapy, monoclonal antibody therapy or a combination. The decision on the exact course of treatment is usually decided on a number of factors. The most important is the stage of your disease. Other factors are also important. The number of nodes involved, the presence of lymphoma in other organs, some blood test reports, and even your age are related to the type of treatment which works best.
Chemotherapy for Aggressive Non-Hodgkin Lymphoma:
Chemotherapy is the main treatment for Non-Hodgkin disease. A combination of 3 or more drugs are generally used. All or most of the drugs are administered either as quick injections or as slow infusions into your veins. Some may be taken as pills. There are a number of effective drug combinations. The most common is called CHOP. The choice of the exact schedule depends on your doctor. Chemotherapy is typically administered every 2-3 weeks for a number of cycles.
Radiotherapy for Aggressive Non-Hodgkin Lymphoma:
Radiation therapy is rarely used alone in Non-Hodgkin Lymphomas. It may be added after a few cycles of chemotherapy. Taking radiation treatment is much like getting an X-ray taken. You lie flat on a couch, and a machine delivers X-rays to a part of your body from a distance. Radiation treatments are usually given 5 days a week for 3-5 weeks. Non-Hodgkin lymphoma responds well to radiation and very high doses are not required.
Antibody Therapy for Aggressive Non-Hodgkin Lymphoma:
Monoclonal antibodies target unique molecules on lymphoma cells and can target these cells specifically. Read more about them in Monoclonal Antibody Therapy - a new way forward. These molecules have shown great results when they have been added to the standard chemotherapy as a part of the initial treatment, as well as a part of treatment in relapsed NHL. Rituximab (Rituxan) is the commonly used drug. It is administered as an injection every week for a few weeks.
Treatment for Early Stage Aggressive Non-Hodgkin Lymphoma:
If you have aggressive Non-Hodgkin Lymphoma in Stage I or Stage II, your treatment usually involves a few cycles of chemotherapy followed by radiation to the areas which were affected by the disease. You may also be offered treatment with monoclonal antibodies as a part of a clinical trial.
Treatment for Advanced Stage Aggressive Non-Hodgkin Lymphoma:
If you have Non-Hodgkin Lymphoma in Stage III or IV, you may be treated with -
- Chemotherapy alone
- Chemotherapy plus monoclonal antibody therapy
- Chemotherapy plus monoclonal antibody therapy followed by radiation to certain areas where disease remains after chemotherapy.
Those with a high risk of relapse may be given a trial of high-dose chemotherapy followed by bone marrow or stem cell transplant.
Treatment for Relapsed Aggressive Non-Hodgkin Lymphoma:
Treatment options include -
- A different chemotherapy combination
- Monoclonal antibody therapy
- High-dose chemotherapy with bone marrow or stem cell transplant
The best treatment method is not known. Most patients respond well to second line treatment, but the duration of response may not be the same for every person.