Cancer drug treatments for lymphoma

Most people have treatment as an outpatient. You usually have a course of treatment over a few days. But sometimes you have it all in 1 day.

Your doctor, nurse or pharmacist will discuss your treatment plan with you. They will give you information about the possible side effects of all the drugs you will have. It is important to follow their advice. Always tell them if you have side effects or if they get worse.

Treatment is usually given into a vein (intravenously). This goes directly into the blood and are carried to all areas of the body. We have more information about how cancer drug treatments are given.

After your first treatment, you have a break of a few weeks without treatment. The break allows your body to recover from any side effects before you start the next cycle.

Treatment and the rest period make up a cycle of your treatment.

Your whole course of treatment may last several months. During this time, you have regular check-ups at the hospital. You usually have a scan before starting treatment and then again at the end. You may also have a scan part way through your course of treatment. These scans show your doctors if the treatment has shrunk the lymphoma.

You may have treatment through a short, thin tube called a cannula. This goes into a vein in your arm or the back of your hand. It is removed after treatment before you go home.

A central line, PICC or port is a tube that can be left in until your whole course of treatment is over. This means you will not need a cannula or needles put into the arm every time you have treatment. Your doctor or nurse can take blood tests from your line or port. You can have antibiotics, fluids and blood transfusions through it too.

When your course of treatment is over, the line or port will be taken out. A doctor or nurse will do this for you, usually in the outpatient department.

Your cancer team will advise you not to get pregnant or make someone pregnant while having cancer drug treatments and for some time afterwards. The drugs may harm a developing baby. It is important to use contraception to prevent pregnancy. Follow their advice about:

• what types of contraception to use
• how long after treatment you should continue to use contraception.

There are many combinations of drugs used to treat non-Hodgkin lymphoma. For example:

• Pola-R-CHP
• O-CVP – a combination of obinutuzumab (Gazyvaro®) and CVP.

The treatment you have will depend on the stage and type of non-Hodgkin lymphoma you have.

Most combination treatments include a targeted therapy drug, chemotherapy and steroid. But you might have a targeted therapy drug by itself in some situations, such as:

• after other treatments to keep the lymphoma in remission for as long as possible – this is called maintenance treatment
• if other treatments have not been effective.

We have more information about different types of non-Hodgkin lymphoma. This includes information about cancer drug treatments used to treat each type.

Chemotherapy into the spinal fluid (intrathecal chemotherapy)

With some types of NHL, there is a higher risk of lymphoma cells spreading to the brain. This can happen with some types of high grade NHL or when lymphoma is in certain areas of the body.

You may have a type of chemotherapy to treat or prevent lymphoma in the brain. This is called intrathecal chemotherapy. A doctor puts a small amount of liquid chemotherapy into the spinal fluid. This is done in a similar way to a lumbar puncture.

You usually have intrathecal chemotherapy as an outpatient. The chemotherapy drug most commonly used is methotrexate.

Another way to treat or prevent lymphoma in the brain is to give high doses of methotrexate into a vein. In this situation, you may not need intrathecal chemotherapy.