Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It is the main treatment for DLBCL.
DLBCL is usually treated with a combination of drugs called R-CHOP. You can have this treatment as an outpatient.
R-CHOP is named after the initials of the drugs used, which are:
- rituximab (Mabthera ®, a type of drug called a monoclonal antibody)
- doxorubicin (hydroxydaunomycin)
- vincristine (Oncovin ®)
- prednisolone (a steroid).
The drugs are given into a vein (intravenously). The treatment is usually given to you every three weeks (every 21 days). You will have up to eight treatments over several months.
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.
DLBCL usually responds well to chemotherapy and treatment may make it disappear (remission). Many people who go into remission are cured but there is a risk that the lymphoma may come back (relapse) in the future. If this happens, different chemotherapy treatments can be used, either with or without rituximab.
Monoclonal antibody therapy
Monoclonal antibodies such as rituximab target certain proteins on the surface of cancer cells. They can either make chemotherapy work better or they can stimulate the body’s immune system to destroy cancer cells.
Other types of monoclonal antibodies are being researched. Some monoclonal antibodies can have small radioactive substances attached to them. This allows them to deliver radiation directly to the lymphoma cells.
Steroids are drugs that are often given with chemotherapy to treat lymphomas. They also help you feel better and can reduce feelings of sickness.
Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to nearby healthy cells. Radiotherapy only treats the area of the body that the rays are aimed at. It may be used when the lymphoma is confined to one or two areas of lymph nodes in the same part of the body (stage 1 or 2). It may be given after chemotherapy. Radiotherapy is also sometimes given to treat symptoms such as pain.
Stem cell treatment (transplants)
Some people with lymphoma may have treatment using stem cells. This treatment is not suitable for everyone. 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.
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 to them by a drip, like a blood transfusion. This is to help the blood cells recover from the effects of chemotherapy. This treatment is called high-dose chemotherapy with stem cell support.
Some people may have treatment using stem cells from another person (a donor). This is called a donor (allogeneic) stem cell transplant.