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Lymphoma (cont.)

Medical Treatment: Biological Therapy

Biological therapies are sometimes referred to as immunotherapy because they take advantage of the body's natural immunity against pathogens. These therapies are attractive because they offer anticancer effects without many of the undesirable side effects of standard therapies. There are many different types of biological therapies. The following are some of the most promising for treating lymphoma:

  • Monoclonal antibodies: Antibodies are substances produced by our body to fight pathogens. Every cell, organism, or pathogen within our body carries markers on its surface that antibodies may recognize. These surface markers are called antigens. A monoclonal antibody is an antibody that is made in a laboratory to find and attach itself to a specific antigen. Monoclonal antibodies can be used to help one's own immune systems kill tumor cells and other pathogens directly, or they can deliver cancer-killing therapies (such as radiation or chemotherapy) directly to a specific antigen found on cancer cells.
  • Cytokines: These naturally occurring chemicals are produced by the body to stimulate the cells in the immune system and other organs. They can also be produced artificially and administered in large doses to patients with greater effect. Examples include interferons and interleukins, which stimulate the immune system, and colony-stimulating factors, which stimulate the growth of blood cells.
  • Vaccines: Unlike the more familiar vaccines for infectious diseases such as polio and flu, cancer vaccines do not prevent the disease. Rather, they are designed to stimulate the immune system to mount a specific response against the cancer. They also create a "memory" of the cancer so that the immune system activates very early in cases of recurrence, thus preventing the development of a new tumor.

Other therapies that are primary or supportive medications are undergoing continuing development and refinement; they include drugs that target cancer cells on a molecular level, various new monoclonal antibodies, and other biologic therapies such as steroids and bone marrow stimulants.

What Other Therapies Treat Lymphoma?

Watchful waiting means choosing to observe and monitor the cancer rather than treat it right away. This is strategy is sometimes used for indolent recurrent tumors. Treatment is given only if the cancer starts to grow more rapidly or to cause symptoms or other problems.

Stem cell transplantation is usually not used as a primary therapy in lymphoma.

  • Stem cell transplantation is usually reserved for lymphoma that has been previously treated into remission but has recurred.
  • Stem cell therapy as primary therapy has been used for aggressive T-cell NHL in first remission, usually as part of a clinical trial. Stem cell therapy is also considered when standard primary treatment is unable to control the lymphoma and achieve remission.
  • This procedure, which requires a lengthy hospital stay, involves very high doses of chemotherapy to kill the aggressive cancer cells.
  • The chemotherapy doses are so high that the chemotherapy also stops the patient's bone marrow from producing healthy new blood cells.
  • The patient then receives a transfusion of healthy bone marrow or blood stem cells, either from previously collected stem cells from the patient himself or herself (called autologous transplantation or autotransplantation) or from a donor (called allogeneic transplantation), to "kick start" the bone marrow into producing healthy blood cells.
  • This is a very intensive therapy with a lengthy recovery period.

Clinical trials

An oncologist may belong to a network of investigators who offer novel treatments for various types of cancers. These novel therapies are newer agents that have been recently developed, and extensive data on treatment results are not yet known. Such new agents can be offered in the context of a clinical trial. Usually, a consent form that explains the drug, its known side effects, its potential side effects, and alternatives to the drug treatment are presented to the patient. If the treatment seems promising for the particular subtype of lymphoma, and the patient is fully educated about the potential benefits and risks associated with such treatment and is interested in receiving such treatment, then the consent form is signed by the patient and the managing physician, and possibly other involved parties. The patient is then enrolled in a treatment protocol that specifies exactly how a patient is to be treated with the new therapy.

Alternatively, an oncologist may refer a patient to another institution to receive investigational treatment or intensive treatment, such as a stem cell transplant.

Complementary/alternative therapies

Several alternative therapies have undergone preliminary testing in lymphoma. None has been found to work better than or as well as standard medical therapies. A few therapies, still felt to be experimental, have been found to be potentially helpful as complements to medical therapy, however.

  • Acupuncture has been helpful in relieving musculoskeletal symptoms, as well as in controlling nausea and vomiting associated with chemotherapy.
  • The supplements coenzyme Q10 and polysaccharide K (PSK) are undergoing further evaluation to determine their effects on treatment outcome. Both drugs have immune enhancing properties. PSK has been used more extensively in Japan as part of an anticancer therapy.
  • Neither of these therapies has undergone extensive blinded studies and cannot be considered a part of any planned therapeutic endeavor.
  • Do not use these therapies unless you first discuss them with your doctor.

What Medications Treat Lymphoma?

Numerous chemotherapy and biological drug combinations may be prescribed by an oncologist. Which type and combination of therapy depends on many factors, including the type and stage of lymphoma, the age of the patient, the ability to tolerate chemotherapy side effects, and if any previous treatment for the lymphoma has occurred. Oncologists often work together regionally to decide which combination of chemotherapy and biological drugs are currently working best for their patients. Because of this regional collaboration, the drug combinations often vary and are able to change rapidly when improved results occur.

What Follow-up May Be Needed After Lymphoma Treatment?

After completion of primary therapy for lymphoma, all appropriate tests will be repeated to see how well the therapy worked.

  • The results of these tests will tell the oncologist whether the patient is in remission.
  • If the patient is in remission, the oncologist will recommend a schedule of regular testing and follow-up visits to monitor the remission and to catch any recurrence early.
  • Keeping up with these visits and tests is very important in order to avoid advanced or widespread disease.

If lymphoma recurs after treatment, the oncologist will likely recommend further treatment.

Medically Reviewed by a Doctor on 5/25/2016

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Lymphoma, B-Cell »

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