Treatment

The choice of therapy is based on how malignant the non-Hodgkin lymphoma is. Less malignant lymphomas, which are still in early stages and have not yet spread significantly, will only be irradiated, as chemotherapy is not sufficiently effective for slowly growing lymphomas. If the lymphoma has already spread further in the body, i.e. in a stage III or IV according to Ann-Arbor, a cure of the disease can no longer be assumed.

In this case, the patient is closely monitored and possible symptoms are treated or a combination of different chemotherapeutic agents can be used. The very malignant non-Hodgkin lymphomas are all treated with the intention of healing. The stage of the disease is also not relevant.

The therapy of choice is a combination of several chemotherapeutic agents. In studies, this has shown a better effect than the use of a single chemotherapeutic agent. In addition to the general therapy approaches listed above, there are specific therapy plans for certain subtypes of non-Hodgkin’s lymphomas that are regularly updated according to the current study situation.

This is the case, for example, with chronic lymphatic leukemia or multiple myeloma. Chemotherapy aims to interrupt the division process of malignant cells in non-Hodgkin’s lymphoma. The various chemotherapeutic agents target different parts of the DNA to cause damage to it.

Subsequently, the cell perishes and is broken down. The chemotherapy does not only affect the degenerated cells but also the healthy cells of the body. The mucous membrane cells of the gastrointestinal tract and the bone marrow are particularly affected.

The destruction of these cells allows us to deduce the side effects of chemotherapy, which can include diarrhea, fatigue, a tendency to infections and spontaneous bleeding. For many of the non-Hodgkin lymphomas a so-called polychemotherapy according to the CHOP scheme is used. It is a combination of the following chemotherapeutic agents: cyclophosphamide, doxorubicin, vincristine and prednisolone.

The first three drugs belong to the chemotherapeutic drugs. Prednisolone is a glucocorticoid, like cortisone. Click here for the main article: ChemotherapyStem cell therapy can be considered if a cure for non-Hodgkin’s lymphoma could not be achieved despite chemotherapy.

A distinction is made between autologous and allogeneic bone marrow transplantation. In autologous transplantation, the patient is given his own bone marrow after a very strong chemotherapy that can kill all lymphoma cells, so that the haematopoietic system in the bone marrow is replaced. In allogeneic transplantation, the patient receives bone marrow from a foreign donor, which matches the patient in certain genetic markers.

Radiation is used for the less malignant non-Hodgkin lymphomas. The affected lymph nodes are selected as the irradiation field. If other tissues are also affected by invasive growth of the lymphoma from the lymph nodes, they can also be irradiated.Radiotherapists try to maintain an important balance during radiation therapy.

On the one hand, the affected tissue should receive as much radiation dose as possible to enable effective tumor control. On the other hand, the surrounding tissue should be spared as much as possible. If the bones are fragile due to non-Hodgkin’s lymphoma or if severe pain is felt there, radiation can also help to make the bones stronger again and relieve the pain. You can find our main article under: Radiotherapy