Malignant Lymphomas: Treatment
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Treatment options for lymphomas depend on the type of lymphoma and its present stage. In most cases, treatment consists of chemotherapy, radiotherapy, or a combination of the two methods.
Chemotherapy is the use of anti-cancer drugs to kill cancer cells. In non-Hodgkin's lymphomas, combination therapy, which involves the use of multiple drugs, has been found more effective than single drug use. The treatment may last about six months, but in some cases may last as long as a year. The drugs may either be administered intravenously (through a vein) in the arm or given orally in the form of pills. If cancer cells have invaded the central nervous system, then chemotherapeutic drugs may be instilled, through a needle in the brain or back, into the fluid that surrounds the brain. This procedure is known as intrathecal chemotherapy.
Radiation therapy, where high-energy ionizing rays are directed at specific portions of the body, such as the upper chest, abdomen, pelvis, or neck, is often used for treatment of lymphomas. External radiation therapy, where the rays are directed from a source outside the body, is the most common mode of radiation treatment.
Bone marrow transplantation is used in cases where the lymphomas do not respond to conventional therapy, or in cases where the patient has had a relapse or suffers from recurrent lymphomas.
There are two ways of doing bone marrow transplantation. In a procedure called "allogeneic bone marrow transplant," a donor is found whose marrow matches that of the patient. The donor can be a twin (best match), a sibling, or a person who is not related at all. High-dose chemotherapy or radiation therapy is given to eradicate the lymphoma. The donor marrow is then given to replace the marrow destroyed by the therapy.
In "autologous bone marrow transplantation," some of the patient's own bone marrow is harvested, chemically purged, and frozen. High-dose chemotherapy and radiation therapy are given. The marrow that was harvested, purged, and frozen is then thawed and put back into the patient's body to replace the destroyed marrow.
A new treatment option for patients with lymphoma is known as "peripheral stem cell transplantation." In this treatment approach, cells that normally circulate in the blood are collected when the patient has normal blood counts taken, and these cells are saved via a process called "pheresis." Researchers are exploring whether these cells can be used to restore the normal function and development of blood cells, rather than using a bone marrow transplant.
— Lata Cherath, PhD
