Refractory and Relapsed
Refractory Non-Hodgkin Lymphoma
Some patients still have cancer cells in their bone marrow after non-Hodgkin lymphoma (NHL) treatment. The term refractory non-Hodgkin lymphoma is used to describe a disease that doesn't go into remission (but may be stable) or that gets worse within six months of the last treatment.
Relapsed Non-Hodgkin Lymphoma
If your lymphoma returns after a remission (no sign of the disease) of six months or more, you've relapsed. You can relapse months or years after treatment. If you relapse a long time after treatment, you may undergo treatment similar to what you received when you were newly diagnosed.
Drugs Used for Refractory and Relapsed NHL
Most patients with refractory or relapsed NHL receive second-line therapy - treatment other than the type used the first time around. Common second-line drug regimens, sometimes followed by stem cell transplantation, include:
- ICE: ifosfamide (Ifex®), carboplatin (Paraplatin®), etoposide (Etopophos®, Toposar®, VePesid®, VP-16)
- RICE: rituximab (Rituxan®), Ifex, carboplatin (Paraplatin®), etoposide
- DHAP: dexamethasone (Decadron®), cytarabine (Cytosar-U®, cytosine arabinoside, ara-C), cisplatin (Platinol®-AQ)
- ESHAP: etoposide, methylprednisolone (Medrol®), high-dose cytarabine, Platinol-AQ
- R-ESHAP: Rituxan, etoposide, Medrol, high-dose cytarabine, Platinol-AQ
If you would like to read about these drugs individually, including information about side effects, click here.
Patients with refractory NHL normally undergo high-dose chemotherapy with stem cell transplantation.
For patients with advanced stage follicular lymphoma, treatment depends on symptoms and how far the disease has spread. For patients who've been treated with chemotherapy using the CHOP regimen, an autologous stem cell transplantation may be an option.