Chemotherapy and Drug Therapy
During chemotherapy, you're given potent drugs that must be toxic enough to damage or kill leukemic cells. At the same time, they take aim at normal cells and cause side effects. Yet, not everyone experiences side effects and people react differently.
Doctors commonly combine four or more chemotherapy drugs to treat non-Hodgkin lymphoma (NHL). Each drug type works in a different way to kill the cancerous cells. Combining drug types can strengthen their effectiveness. You may be given the drugs as pills to swallow, by injection or through a catheter (a thin, flexible tube or intravenous line) surgically placed in a vein, normally in your upper chest.
Chemotherapy is given in cycles, usually several weeks apart, in an outpatient setting. You'll need a number of cycles over six to 10 months. You may need to remain in the hospital for a short period during treatment if your therapy is particularly intensive or if it leads to infection or prolonged or severe decreases in blood cell counts.
A common chemotherapy drug regimen for NHL is called CHOP. The names of the combinations are usually abbreviations for the first letter of the drugs used. The drugs in CHOP are:
- cyclophosphamide (Cytoxan®)
- doxorubicin (hydroxydoxorubicin)
- vincristine (Oncovin®)
Doctors may add the monoclonal antibody rituximab (Rituxan®) to this mix, which can aid in the treatment's effectiveness by targeting specific molecules on cancer cells. Called R-CHOP, this is one of the more commonly used chemotherapy and monoclonal antibody therapy combinations for aggressive NHL. It can be very effective and sometimes cures NHL.
If you would like to read about these drugs individually, including information about side effects, click here.
Other Drug Therapies
Doctors use a vast array of drugs to treat the different NHL subtypes, attacking them from many different angles:
- DNA-damaging drugs stop cancer cell growth by chemically changing the DNA that's helping NHL develop.
- Antitumor antibiotics interact with DNA to interfere with cancer cell survival.
- Antimetabolites are chemicals that block cells' ability to form DNA or RNA, which prevents cell growth.
- Proteasome inhibitor drugs limit the effects of a cell structure called proteasome, which make it harder for cancer cells to survive.
- DNA repair enzyme inhibitors attack certain enzymes (proteins) in cells to make DNA more susceptible to injury.
- Chemotherapy drugs block a process called mitosis, which stops cells from dividing, thus limiting cancer cell production.
- Lymphocyte-killing hormones, related to the natural hormone cortisol, are used in high doses to destroy cancer cells.
- Monoclonal antibodies, used during immunotherapy, are a class of agents that target and destroy cancer cells with fewer side effects than traditional chemotherapy.
For a list of drugs used to treat NHL, download or order The Leukemia & Lymphoma Society's (LLS's) free booklet Non-Hodgkin Lymphoma.