Treatments for Lymphoma

There is no single approach to treating lymphoma. It’s a disease that requires careful, highly personalized management. That’s why it’s important to go to a center that can tailor your care plan to your cancer and draw from a broad range of treatment options.

At Siteman Cancer Center, our Washington University oncologists give each lymphoma patient the treatment that is best for them. For some patients, chemotherapy is sufficient. Other patients will be treated with a combination of therapies that might include immunotherapy, targeted therapy, and even CAR T-cell therapy.

Many lymphoma patients at Siteman receive treatment through clinical trials. These studies evaluate the newest drugs and therapies, allowing patients to access ground-breaking treatments that have not yet been released on the market. Clinical trials can be a game-changer for patients who have not found success with other forms of treatment.

Siteman Cancer Center houses more clinical trials than any other facility in the region. As active researchers, your physicians will know which trials might be a good fit for you and will be able to enroll you if necessary.

Your Siteman care team will be sure to discuss all of your options with you and answer any questions you might have.

What treatments are used for Non-Hodgkin lymphoma?

Non-Hodgkin lymphoma patients are treated with one or more of the following methods:

  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Immunotherapy
  • Stem cell transplant
  • CAR T-cell therapy

What treatments are used for Hodgkin lymphoma?

Most patients with Hodgkin lymphoma can be cured with a regimen of chemotherapy alone. If the cancer recurs, they will usually receive a stem cell transplant combined with high-dose chemotherapy to eliminate the cancer and replenish the bone marrow’s stem cells.

Though many cases of Hodgkin lymphoma are straightforward to treat, your Washington University oncologists will also know how to plan for the unexpected and work creatively to bring you positive results.

Medical Treatment

Chemotherapy for lymphoma

The first line of treatment for lymphoma often involves chemotherapy. Chemotherapies are drugs that kill cancer cells. Patients may receive them as oral medications or as intravenous infusions.

Even aggressive non-Hodgkin lymphomas can often be cured with chemotherapy.

Patients undergo chemotherapy in cycles consisting of treatment days and rest days. They will likely receive more than one drug at the same time.

Chemotherapy can cause a number of difficult side effects, including nausea and extreme fatigue. Your team will help you manage the side effects as they occur. Some patients find palliative care (or care that seeks to reduce pain and improve quality of life) to be helpful as well.

Targeted therapy

Cancer cells use many different tactics to multiply and spread. Targeted therapies are drugs that disable these tactics, rather than eliminating the cells as a whole. They try to prevent cancer cells from growing while protecting the normal cells around them.

Targeted therapy is administered intravenously or as a pill, depending on the medication.

There are a number of targeted therapy drugs available for lymphoma, and side effects can vary widely. Sometimes, the side effects are less severe than those associated with traditional chemotherapy.

Lymphoma patients typically receive targeted therapy after first trying chemotherapy.

Immunotherapy

Unlike diseases caused by foreign pathogens such as viruses and bacteria, cancer develops from the cells of the patient’s own body. This means that the immune system doesn’t recognize cancer cells as dangerous and fails to take action against them.

Immunotherapy is a new form of treatment that alerts the immune system to malignant cancer cells and helps it to destroy them.

Several different types of immunotherapy can treat lymphoma. They are usually administered as drugs.

Antibody-based medications are a type of immunotherapy used to treat lymphoma. These antibodies attach to the lymphoma cells and flag the patient’s immune system to eliminate these cells. Radioimmunotherapy is a treatment that uses antibodies to deliver targeted radiation to lymphoma cells. Chemoimmunotherapy similarly delivers chemotherapy to lymphoma cells by using an antibody as a vehicle. These can be used as a solo treatment or in combination with chemotherapy.

Physicians and researchers at Siteman are also working to develop a vaccine for patients with follicular lymphoma.

Radiation Therapy

Some patients with lymphoma will receive radiation therapy. Like chemotherapy, radiation therapy has long been a mainstay of cancer treatment. It uses concentrated X-ray beams to shrink tumors and kill cancer cells.

The Washington University radiation oncologists at Siteman Cancer Center are highly skilled at using advanced strategies to deliver radiation directly to the lymphoma, minimizing the effects on other parts of the body. Siteman is also a national leader in using shorter courses of radiation therapy while still achieving excellent outcomes.

At Siteman, lymphoma patients may receive MR-guided adaptive radiation therapy, a technique developed here at our facility. During MR-guided therapy, the radiation oncologist uses MR imaging to supervise the delivery of radiation. The imaging allows them to watch the radiation impact the tumor in real time and to make adjustments as needed.

Many patients with lymphomas that are difficult to visualize on X-ray or CT scans have been treated with MR-guided therapy. Siteman Cancer Center was the first facility in the world to perform this technique.

Other times, lymphoma patients might benefit from a method called proton beam therapy. The S. Lee Kling Proton Therapy Center at  Siteman Cancer Center was the first proton therapy center located in Missouri and the surrounding region, and houses the world’s first proton beam accelerator. Proton beam therapy differs from traditional radiation therapy in that the beam does not pass through the body: instead, it stops directly within the target. This treatment is ideal for patients with tumors that are located near sensitive structures or tissues, such as the heart, brain, or spinal cord.

CAR T-cell therapy

CAR T-cell therapy is a new form of lymphoma treatment that modifies the patient’s immune system cells so they can attack lymphoma cells. This therapy, developed and evaluated in part at Siteman Cancer Center, can help patients with certain kinds of lymphoma achieve positive results.

Stem Cell Transplant

Some lymphoma patients may need a stem cell transplant in order to achieve remission or cure.

All of the blood cells in your body are produced by blood-forming stem cells that reside in the bone marrow. These cells can become too damaged by lymphoma or chemotherapy to work anymore. If that happens, a transplant can restore the bone marrow’s supply of stem cells and allow them to produce healthy blood cells again. Stem cell transplants are commonly referred to as bone marrow transplants.

Siteman Cancer Center specializes in performing safe, effective stem cell transplants.