What Happens During Chemotherapy for Non-Hodgkin Lymphoma

What Happens During Chemotherapy for Non-Hodgkin Lymphoma

How you get chemotherapy and how often you get it depends on the drugs you take. Here is what is generally true for people with non-Hodgkin lymphoma who are getting chemotherapy as part of their treatment.

How you take chemotherapy drugs

Most people have chemotherapy in an outpatient part of the hospital, at the doctor's office, or at home. However, depending on the drugs you are getting and your health, you may need to stay in the hospital during treatment. You may take these drugs in pill form, by injection or IV, into the spinal fluid, or in more than 1 way. To treat lymphoma, intravenous (IV) injection is most common.

Because you may need to have an IV for chemotherapy more than once, it can be helpful to have an intravenous catheter. This is also called a venous access device. This catheter is a small tube that remains in place for a long period of time so that you don't have a new IV started each time you get treatment. One end of the tube is placed into a vein near your heart. The other end is placed just under the skin or even comes out through the skin where it is readily available for connecting to the chemotherapy. The catheter is put in place during a minor surgical procedure. Talk with your health care team about the risks and advantages of having a venous access device or catheter.

How often you get chemotherapy

You get chemotherapy in cycles over a period of time. That means you may take the drugs more than once. And that means you'll have rest periods in between getting the drugs. These drug cycles help in several ways. They allow the drugs to kill more lymphoma cells because cells aren't all dividing at the same time. They allow your body to rest from the chemotherapy. They also give you an emotional break between treatments.

Chemotherapy drugs that are common for non-Hodgkin lymphoma

You are likely to have combination chemotherapy. Taking more than 1 type of medicine reduces the chance that the lymphoma will develop a resistance to 1 drug. And that, in turn, improves the chance of successful treatment. Which drugs you get and how often you take them depend on many factors, including your health.

For B-cell lymphomas, these are chemotherapy drugs that are commonly used. The first 4 are often combined in a regimen called CHOP:

  • Cyclophosphamide

  • Doxorubicin

  • Vincristine

  • Prednisone or dexamethasone

  • Chlorambucil

  • Cytarabine

  • Mitoxantrone

  • Etoposide

  • Methotrexate

  • Fludarabine

  • Pentostatin

  • Cladribine, also known as 2-CdA

  • Bendamustine

For T-cell lymphomas, these are chemotherapy drugs that are commonly used:

  • Cyclophosphamide

  • Doxorubicin

  • Vincristine

  • Cytarabine

  • Mitoxantrone

  • Etoposide

  • Methotrexate

  • Prednisone or dexamethasone

  • Carboplatin or Cisplatin

  • Ifosfamide

  • Gemcitabine

  • Oxaliplatin

  • Pralatrexate

You may also receive drugs called colony-stimulating factors. These help your white blood cells recover from the effects of chemotherapy. Two examples are filgrastim or sargramostim. These drugs may be especially helpful if you have AIDS and are being treated for non-Hodgkin lymphoma.

For many types of non-Hodgkin lymphoma, chemotherapy drugs are given in combination with other drugs called monoclonal antibodies, such as rituximab.  

 
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