Chemotherapy for lymphoma

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.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells. Cytotoxic chemotherapy drugs disrupt the way cancer cells grow and divide.

Most people have chemotherapy as an outpatient. Usually, you have a combination of different 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.

Your course of treatment is usually given over a few days. But sometimes you have it all in one day. After your first treatment, you have a break of a few weeks without treatment. This 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 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.

Chemotherapy for non-Hodgkin lymphoma

Your doctor and nurse will talk to you about the chemotherapy that is best for your situation. This depends on the type of lymphoma you have and whether it is low-grade or high-grade.

Chemotherapy is often given along with a targeted therapy drug. This is commonly used to treat B-cell lymphomas. Some people may have chemotherapy on its own or with radiotherapy.

Some targeted drugs also work on the immune system, so are sometimes described as immunotherapy drug. When you have them with chemotherapy it is sometimes called chemoimmunotherapy.

Chemotherapy drugs for non-Hodgkin lymphoma

Combinations of different drugs are named after the initials of the drugs used. These are the most common chemotherapy and chemoimmunotherapy treatments for NHL:

If the lymphoma does not completely respond to chemotherapy, your doctor may advise different or stronger drugs than you had before. If this happens the lymphoma can still be treated successfully.

Sometimes your doctor may talk to you about having intensive chemotherapy and a stem cell transplant.

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.

Chemotherapy for Hodgkin lymphoma

Your doctor or nurse will explain how much chemotherapy you will have and how long your treatment will take. This will depend on the stage and type of Hodgkin lymphoma you have. Sometimes your doctor may advise changes to your chemotherapy drugs. This depends on your situation.

Usually chemotherapy works very well for most people with Hodgkin lymphoma. But sometimes the lymphoma may not completely respond to the treatment. If this happens it can still be treated successfully. Your doctor may talk to you about having more intensive chemotherapy with a stem cell transplant.

The most commonly used chemotherapy treatments for Hodgkin lymphoma include a combination of different drugs. They are named after the initials of the drugs used.

The combination drugs used to treat Hodgkin lymphoma may include:

Some people have a higher risk of more serious side effects with ABVD and BEACOPP. Depending on your general health and age, your doctor may suggest chemotherapy combinations that have fewer side effects. These include:

Side effects of chemotherapy for lymphoma

Chemotherapy can cause different side effects. These vary depending on the drugs you have.

Side effects can usually be well controlled with medicines. Most side effects usually go away once treatment has finished. Your doctor or nurse will tell you about the most likely side effects and how they can be controlled or managed. They will also talk to you about the risk of possible late effects.

We have more information about the side effects of chemotherapy.

About our information

  • References

    Below is a sample of the sources used in our lymphoma information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.

    Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2018).

    Non-Hodgkin’s lymphoma: diagnosis and management; NICE Guideline (July 2016).

    Newly Diagnosed and Relapsed Follicular Lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2020).

  • Reviewers

    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 Editor, Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.