Chemotherapy with monoclonal antibody treatment, called immunochemotherapy, is the main treatment for mediastinal B-cell lymphoma.
Other treatments such as radiotherapy are also used. You may have a combination of different treatments.
Mediastinal large B-cell lymphoma usually responds well to immunochemotherapy, but in some people the lymphoma comes back and further treatment is needed. This may include a stem cell transplant.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. You will usually have a combination of different chemotherapy drugs given into the vein (intravenously), either as injections or through a drip (infusion). Your specialist will explain which combination of drugs is most appropriate for you.
A commonly used chemotherapy combination is the R-CHOP regimen. This includes the chemotherapy drugs vincristine, cyclophosphamide, doxorubicin, the steroid prednisolone, and a monoclonal antibody called rituximab (Mabthera ®).
Another chemotherapy combination that may sometimes be used is DA-EPOCH-R. This includes the chemotherapy drugs etoposide, vincristine, cyclophosphamide and doxorubicin, the steroid prednisolone, and the monoclonal antibody rituximab. ‘DA’ stands for ‘dose-adjusted’ as the dose of drugs can be adjusted depending on how your body responds to the treatment.
Monoclonal antibody therapy
Monoclonal antibodies are drugs that recognise, target and stick to particular proteins on the surface of cancer cells, and can stimulate the body’s immune system to destroy these cells
Rituximab is the main monoclonal antibody drug used to treat mediastinal large B-cell lymphoma. It's given as a drip (infusion). Rituximab is usually given with chemotherapy as part of the R-CHOP regimen.
Stem cell treatment (transplants)
Some people with lymphoma may have treatments using their own stem cells or stem cells from a donor. Stem cells are a special type of blood cell that can make all other types of blood cells.
This treatment is not suitable for everyone. It may be used if the lymphoma doesn’t respond to treatment or if it comes back after treatment. Doctors take into account a person's general health and fitness before recommending it.
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.
Some people may have treatment using stem cells from another person (a donor). This is called a donor (allogeneic) stem cell transplant.
Radiotherapy is the use of high-energy rays to destroy cancer cells while doing as little harm as possible to the healthy cells. Radiotherapy is sometimes given to the area where the lymphoma was after chemotherapy treatment.
Steroids are often given with chemotherapy to help treat lymphomas. They can also help you feel better and reduce feelings of sickness (nausea).