Lymphoma

What Treatments Are Available For Lymphoma?

The methods of treatment used for lymphoma include:

• Chemotherapy (drugs) and radiation therapy
• Bone marrow transplant
• Biologic therapy

The combination of drugs and therapies used will depend on the type of lymphoma.

Chemotherapy And Radiation Therapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for non-Hodgkin’s lymphoma usually includes a combination of several drugs.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors.

Chemotherapy and radiation therapy are the most common treatments for non-Hodgkin’s lymphoma. Because of the risk that a lymphoma has spread beyond the original tumor, surgery alone isn’t usually enough.

Chemotherapy is called a systemic treatment because the drugs travel throughout the body. This means that even those cancer cells that have not yet been found may be killed. Patients may receive chemotherapy alone or in combination with radiation therapy.

For further information about radiation therapy, go to Radiation Therapy.

Bone Marrow Transplant

One form of chemotherapy, called high-dose chemotherapy (HDCT), uses very high doses of toxic drugs to kill all possible tumor cells. Because these high doses also kill most of the bone marrow, patients are then given a bone marrow transplant to restore their ability to make new red and white blood cells.

Bone marrow may be taken from the patient before chemotherapy begins and given back to the patient after treatment is done. Or, bone marrow from another person may be used.

Biological Therapy

We now understand a great deal about cancer and the body’s defense systems. Biological therapy, also called biological response modifier therapy (BRMT), uses chemicals made by the body’s own cells in order to activate the body’s defenses against cancer.

Many biological therapies are still experimental, but research is being done to develop and improve them. Scientists and doctors hope that they will soon be able to treat most forms of cancer using these therapies, combined with treatments like chemotherapy and radiation therapy.

The different approaches to biological therapy include:

• Immunotherapy
• Angiogenesis inhibitors
• Gene therapy

Immunotherapy

In one kind of immunotherapy, chemicals called cytokines are used to activate white blood cells. Sometimes, when the immune system is activated in this way, it will fight and kill tumor cells. Two cytokines being used are called interferon and interleukin.

Antibodies are proteins that help white blood cells fight off viruses and bacteria. Antibodies bind to foreign invaders and signal the immune cells to attack. Monoclonal antibodies are antibodies that are made in the laboratory to bind to only one single type of molecule.

Many cancer cells carry proteins called tumor antigens on their surface. Because cancer cells are usually the only ones to carry these proteins, tumor antigens make good targets. Researchers hope that monoclonal antibodies against these tumor antigens will bind to them and signal the immune system to attack the tumor cells.

Two approaches are being studied for treating cancer with monoclonal antibodies. In one, the antibodies signal the body’s own immune cells to attack and kill the tumor cells. In the other, powerful anti-cancer drugs are linked to monoclonal antibodies which then carry the drugs straight to the tumor. This means that the drug is aimed directly at the cancer cells rather than at healthy tissues.

The U.S. Food and Drug Administration (FDA) has approved Rituxan, a monoclonal antibody for treating lymphoma, and are considering approval of a similar drug, Bexxar. Rather than binding to proteins found only on cancer cells, these two antibodies bind an antigen found on almost all B-lymphocytes. This causes both cancerous and healthy, mature B-lymphocytes to be killed. But because the youngest B cells in the body do not have the antigen, they are not affected by the treatment, and can grow and mature to replace those that were killed during treatment.

Another new immunotherapy is the use of tumor vaccines. In much the same way that a polio vaccine activates your immune system to fight off the virus if you are ever infected, tumor vaccines use a person’s own tumor cells to activate the immune system to destroy the tumor.

Angiogenesis Inhibitors

Angiogenesis inhibitors are chemicals that block the formation of new blood vessels. Tumors need to create a whole new blood supply in order to keep growing, so they cause new blood vessels to be formed. In mice, angiogenesis inhibitors have blocked the growth of many types of cancer. This highly experimental form of treatment has been successful in mice. Clinical trials are underway to test the treatment in people.

Gene Therapy

In gene therapy, pieces of DNA are placed into cells to correct something that has gone wrong with those cells, or to make the cells self-destruct. Because most cancers are now known to result from damage to genes that keep cells from growing out of control, gene therapy of cancer cells may someday be able to correct the problem or force cancer cells to destroy themselves. Gene therapy for cancer is still highly experimental.