Lymphoma therapy should be started immediately after diagnosis to prevent further progression of the disease. In the treatment of Hodgkin’s lymphoma, both chemotherapy and radiotherapy are used in combination. Surgical treatment is not used, as these are systemic diseases and the removal of corresponding lymph nodes is likely to result in further lymph node enlargement.
Which chemotherapeutic drugs are used depends on the type of lymphoma and its stage. The administration of the drugs is repeated until a certain number of cycles is reached. Radiation therapy may then be applied.
In advanced stages, chemotherapy is usually carried out for 8 cycles, which corresponds to a period of six to seven months. In earlier stages, two cycles are usually given and radiotherapy is followed. If the disease spreads further in the body during or after therapy, this is called progression, and high-dose chemotherapy becomes necessary.
Furthermore, in these cases a stem cell transplantation will be necessary. An early relapse is when more than three months have passed since the end of therapy but not yet a full year has been reached. In the case of a late relapse, the one year mark has already been exceeded.
Both chemotherapy and radiation therapy have a variety of side effects. Despite constant development of the drugs, these side effects decrease, but can never be completely prevented. For example, with the chemotherapeutic drugs of the newer generation, nausea and vomiting, which were previously often uncontrollable, can be controlled with the help of combination preparations.
However, dangerous blood count changes often occur, which weaken the immune system to such an extent that there is an increased risk of infection. Regular blood count checks are therefore absolutely necessary. Since there is a general inhibition of cell division, hair loss is to be expected with most chemotherapeutic drugs.
Furthermore, damage to the nerve cells in the body with tingling and numbness, but also paralysis with loss of function of individual parts of the body can occur. The side effects of radiation therapy are rather localized to the irradiated area and range from slight reddening of the skin to burns, shocks, loss of taste and smell. Fatigue during radiotherapy is reported by most patients.
The treatment of non-Hodgkin’s lymphomas depends on the subgroup and is very complex. In principle, however, it also consists of chemotherapy combined with radiation treatment. Other therapeutic options include cytokine therapy, which aims to stimulate the immune system, and antibody therapy.
Here, too, a stem cell transplantation can be considered in case of non-response. In the case of very slow progression of non-Hodgkin’s lymphomas, it is possible to initially forego therapy and closely monitor the patient’s blood count. However, treatment may then become necessary in the further course of the disease.
In chronic lymphocytic leukemia, treatment only makes sense if the disease is at a very advanced stage or if the patient has symptoms in an early stage. The following options are available for treatment: chemotherapy and monoclonal antibodies. Both surgical therapy options and radiotherapy play no role in the treatment of chronic lymphatic leukemia.
Here, too, there are numerous comprehensive treatment regimens that provide for the combined administration of chemotherapeutic agents. The treatment of a first-line patient is called first-line therapy. If a relapse occurs, this therapy is called second line therapy.
