Chemotherapy is often used to treat lymphoma. It uses anti-cancer (cytotoxic) drugs to destroy lymphoma cells. Cytotoxic means the drugs are toxic to cells.
Most people have chemotherapy as an outpatient. Usually you have a combination of two or more chemotherapy drugs. The drugs are usually given as liquids into a vein (intravenously) or as tablets. We have more information about how chemotherapy is given.
You have the chemotherapy drugs over one or a few days. Then you have a break of a few weeks without chemotherapy. The treatment and break is called a cycle of treatment. The break allows your body to recover from any side effects before you start the next cycle.
Your whole course of chemotherapy treatment may last several months. During this time, you have regular check-ups at the hospital. You usually have a scan before starting chemotherapy and then again at the end. You may also have a scan part of the way through your course of treatment. These scans help check how the treatment has worked in shrinking the lymphoma.
The most commonly used treatments for NHL include:
- CHOP – this is a combination of the chemotherapy drugs cyclophosphamide, doxorubicin (hydroxydaunorubicin) and vincristine (Oncovin®) given into a vein, and steroid tablets called prednisolone.
- CVP – this is a combination of the chemotherapy drugs cyclophosphamide and vincristine given into a vein, and prednisolone tablets. Sometimes a drug called gemcitabine is added to CVP, to make a treatment combination called GCVP.
Chemotherapy may be given in combination with a targeted therapy. The most commonly used targeted therapy is a monoclonal antibody called rituximab. This is often used to treat B-cell lymphomas. When chemotherapy and rituximab are given together, the letter R is added to the treatment name, for example R-CHOP or R-CVP. The combination of chemotherapy and rituximab is sometimes called chemoimmunotherapy.
Intrathecal chemotherapy for NHL
With some types of NHL, there is a higher risk of lymphoma cells getting into the brain. This can happen with some types of high-grade NHL or when lymphoma is in certain areas of the body.
Doctors use extra treatment to treat or prevent lymphoma in the brain. The doctor puts a small amount of liquid chemotherapy into the spinal fluid. This is called intrathecal chemotherapy. 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, intrathecal chemotherapy may not be needed.
The most commonly used treatments for Hodgkin lymphoma include the following:
- ABVD – this is a combination of the chemotherapy drugs doxorubicin (Adriamycin®), bleomycin, vinblastine and dacarbazine (DTIC). They are given into a vein.
- BEACOPP – this is a combination of the chemotherapy drugs bleomycin, etoposide, doxorubicin (Adriamycin®), cyclophosphamide, vincristine (Oncovin®) and procarbazine. These are given into a vein except procarbazine, which you take as tablets. You also take steroid tablets called prednisolone.
For some people, there is a higher risk that ABVD and BEACOPP may cause more serious side effects. Depending on your general health and age, your lymphoma doctor may suggest another chemotherapy that is safer for you. This may include:
- VEPEMB – this is a combination of the chemotherapy drugs vinblastine, cyclophosphamide, procarbazine, etoposide, mitoxantrone and bleomycin. These are given into a vein except procarbazine and etoposide, which you take as tablets. You also take prednisolone tablets.
- ChIVPP – this is a combination of one chemotherapy drug that is given into a vein and two types of chemotherapy tablets. The drugs are chlorambucil, vinblastine, procarbazine. You also take called prednisolone tablets.
Chemotherapy can cause side effects. These vary depending on the drugs you have. Your cancer doctor, nurse specialist or pharmacist will explain the side effects that your chemotherapy is likely to cause.
We have more information about the side effects of chemotherapy.
Hodgkin lymphoma (HL) references
Below is a sample of the sources used in our Hodgkin lymphoma (HL) information. If you would like more information about the sources we use, please contact us at email@example.com
Collins G, et al. Guideline on the management of primary resistant and relapsed classical Hodgkin lymphoma. British Journal of Haematology. 2014. 164: 39–52. Available from:http://onlinelibrary.wiley.com/doi/10.1111/bjh.12582/pdf
Follows G, et al. Guidelines for the first line management of classical Hodgkin lymphoma. British Journal of Haematology. 2014. 166: 34–49. Available from:http://onlinelibrary.wiley.com/doi/10.1111/bjh.12878/pdf
McKay P, et al. Guidelines for the investigation and management of nodular lymphocyte predominant Hodgkin lymphoma. British Journal of Haematology. 2016. 172: 32–43. Available from: http://onlinelibrary.wiley.com/doi/10.1111/bjh.13842/epdf
Treleaven J, et al. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. British Journal of Haematology. 2011. 152: 35–51. Available from:http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2141.2010.08444.x/full.
Non-Hodgkin lymphoma (NHL) references
Below is a sample of the sources used in our non-Hodgkin lymphoma (NHL) information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
National Institute for Health and Care Excellence (NICE). Guideline NG46. Haematological cancers: improving outcomes. 2016.
National Institute for Health and Care Excellence (NICE). Guideline NG52. Non-Hodgkin’s lymphoma: diagnosis and management. 2016.
Treleaven, et al. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. British Journal of Haematology. 2011.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Anne Parker, Consultant Haematologist; and Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.
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