What Is Lymphoma?
Lymphoma is a form of cancer that affects the
lymph system. This system includes:
- lymph nodes
- bone marrow
- lymph fluid
While many types of lymphoma exist, doctors
divide them into two categories. These are Hodgkin lymphoma and non-Hodgkin
Patients with Hodgkin lymphoma have cells known
as Reed-Sternberg cells. Those with NHL don’t have these cell types. Both
lymphoma forms can cause similar symptoms.
Treatments for either lymphoma type depend on the
specific cells affected and the cancer type. In addition to radiation
treatments to kill cancerous cells and shrink tumors, doctors often prescribe
medications to patients to treat the cancerous cells or the lymphoma symptoms.
Hodgkin Lymphoma Chemotherapy Drugs
Chemotherapy drugs are
medications used alone or in combination to target lymphoma cells. These drugs kill
cancer cells or keep them from multiplying. Chemotherapy medications can treat
Chemotherapy medications often
involve combining several drugs together for optimum results. Doctors give the
medications via an intravenous (IV) treatment. Special IV lines called a port
or port-a-cath are used to deliver these medications. The port provides access
to a large vein, usually in the chest. This prevents vein damage from the
Three chief chemotherapy regimens
for Hodgkin lymphoma exist.
doxorubicin (Adriamycin), bleomycin (Blenoxane), vinblastine (Cytoxan), and
blenoxane, etoposide (Etopophos, Toposar, VePesid, VP-16, Adriamycin,
cyclophosphamide (Cytoxan), vincristine (Oncovin), procarbazine (Matulane), and
V: mechlorethamine (Mustargen), adriamycin, cytoxan, oncovin, blenoxane,
Doctors prescribe the Stanford V
regimen to patients with advanced lymphoma forms. Doctors are more likely to
prescribe the ABVD regimen for earlier stages.
Non-Hodgkin Lymphoma Chemotherapy Drugs
Doctors prescribe chemotherapy to
treat NHL. Similar to drugs used for Hodgkin lymphoma treatments, pharmacists
mix several chemotherapy medications together. These medication types fall into
six categories. Doctors select a medicine based on the lymphoma type and stage.
Alkylating agents keep cells from replicating by destroying DNA.
While effective, they are associated with increased risk for leukemia. Examples
- cyclophosphamide (Cytotoxan)
- bendamustine (Treanda)
- ifosfamide (Ifex)
Corticosteroids kill cancerous cells, prevent the cancerous cells
from growing, and can reduce nausea. Examples of these medications include:
- dexmethasone (Decadron)
Platinum drugs work similarly to alkylating agents without the
increased risk for leukemia. Examples of these drugs include:
Purine analogs reduce cell
metabolism to keep cancerous cells from reproducing and dividing. Medication
- cladribine (2-CdA, Leustatin)
- fludarabine (Fludera)
- pentostatin (Nipent)
Antimetabolites prevent DNA and RNA from growing and killing the
cancerous cells. Examples include:
- capecitabine (Xeloda)
- cytarabine (ara-C)
- gemcitabine (Gemzar)
- pralatrexate (Folotyn)
Additional medications used to treat lymphoma but don’t fit into a particular
- doxorubicin (Adriamycin)
- etoposide (VP-16)
- vincristine (Oncovin)
According to the
American Cancer Society (ACS) , CHOP is a
common NHL chemotherapy regimen. Pharmacists combine cyclophosphamide
(Cytotxan), doxorubicin (hydroxydoxorubicin), vincristine (Oncovin), and
Doctors may add rituximab
(Rituxan) to this regimen, which is known as R-CHOP. According to the
Leukemia & Lymphoma Society (LLS) , the
R-CHOP regimen treats more aggressive forms of non-Hodgkin lymphoma. This
method can cure NHL in some patients.
The combination of
cyclophosphamide, vincristine, and prednisone (CVP) is another regimen.
Non-Hodgkin Lymphoma Immunotherapy Drugs
Immunotherapy can boost the
body’s immune system to fight cancer in NHL patients. In addition to fighting
cancer, immunotherapy drugs can minimize some of chemotherapy’s side effects,
including nausea and fatigue.
These medications are often
called “guided missiles.” They specifically target cancer cells, unlike other chemotherapy medications that can harm
healthy cells that multiply quickly, such as hair cells.
Immunotherapy medications that
treat NHL include:
- immune modulators, including thalidomide
(Thalomid) and lenalidomide (Revlimid)
- monoclonal antibodies, such as rituximab (Rituxan)
- proteasome inhibitors, such as bortezomib
- small molecule treatments, such as panobinostat
A doctor may prescribe these or
other treatments, depending upon the patient’s NHL type.