Chemotherapy is the main treatment for BL. Usually an intensive treatment, which means staying in hospital for a few weeks, will be given. A monoclonal antibody drug called rituximab (Mabthera ®) may be given in addition to chemotherapy. Some people may have stem cell treatment.
Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. The combination of drugs you have will depend on the stage of the lymphoma and how well you are to cope with the side effects. The chemotherapy drugs are given into a vein (intravenously). The following drugs may be used in different combinations to treat BL:
Your specialist will talk to you about which combination of the drugs you will have.
Chemotherapy can also be given into the spinal fluid to allow the drug to reach the spinal cord and brain (central nervous system). This is called intrathecal chemotherapy. It is done either to prevent lymphoma cells from spreading into the cerebrospinal fluid or to treat it if it already has.
Monoclonal antibody therapy
Monoclonal antibodies such as rituximab (Mabthera®) may target certain proteins on the surface of cancer cells. They can either make chemotherapy work better or stimulate the body’s immune system to destroy the cancer cells.
Steroids are drugs that are often given with chemotherapy to help treat lymphomas. They also help you feel better and can reduce feelings of sickness.
Tumour lysis syndrome (TLS)
Chemotherapy may cause the cancer cells to break down very quickly. This can cause chemical imbalances in the blood that affect the kidneys and the heart. This is called tumour lysis syndrome (TLS).
To reduce the risk of TLS, your doctor may give you a drug called rasburicase as a drip (infusion). You will also be given fluids through your drip to help protect your kidneys. You may only need rasburicase with the first treatment. After that, you can have tablets called allopurinol (Zyloric®) instead.
Stem cell treatment (transplants)
Some people with lymphoma may have treatment using stem cells. Stem cells are blood cells at their earliest stage of development. All blood cells develop from stem cells.
There are two different types of stem cell treatment, but they are not suitable for everyone.
Using your own stem cells
Some people have some of their own stem cells collected and stored. This allows them to have higher doses of chemotherapy to destroy the lymphoma cells. After the chemotherapy, their stem cells are returned by a drip (like a blood transfusion) to help their blood cells recover from the effects of chemotherapy. This is called high-dose chemotherapy with stem cell support.
Using stem cells from a donor
Some people may have treatment using stem cells from another person (a donor). This is called a donor (allogeneic) stem cell transplant.