Treatment Options for Hodgkin & Non-Hodgkin Lymphoma
The lymphoma treatment specialists at Moffitt Cancer Center provide the most effective therapies available for both Hodgkin and non-Hodgkin lymphoma patients. Our physicians specialize in Hodgkin lymphoma and all forms of non-Hodgkin lymphoma, including B-cell lymphomas like follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, mantle cell lymphoma, Burkitt’s lymphoma, lymphoplasmacytic lymphoma, and AIDS-related lymphomas, especially central nervous system lymphoma. We can also address T-cell lymphomas, such as peripheral and cutaneous T-cell lymphoma, and T-cell large granular lymphocytic leukemia.
How is Lymphoma Treated?
Therapies that our Hodgkin and non-Hodgkin lymphoma specialists may recommend for the treatment of patients include:
- Chemotherapy – Medications are used to destroy cancerous cells. These medications may be delivered intravenously or orally.
- Immunotherapy – Man-made antibodies or genetically modified cells are used to help the patient’s immune system destroy or slow the growth of cancer cells, including CAR T-cell therapy
- Stem cell transplantation – Radiation therapy or chemotherapy can destroy a patient’s healthy blood cells along with the targeted cancer cells. A stem cell transplant replaces abnormal cells with new, healthy stem cells.
- Radiation therapy – High-energy beams are delivered to the body to destroy cancerous cells.
- Radioimmunotherapy (RIT) – RIT is the combination of radiation therapy and immunotherapy into one treatment. It involves using biologic substances to deliver the radiation to the cancerous cells.
- Photopheresis – This is a type of photoimmune therapy, used to help the immune system fight certain types of lymphoma and graft versus host disease, which can sometimes occur with stem cell transplantation.
- Phototherapy – UV light is used to destroy cancerous cells in the skin.
- Surgery - Surgery is rarely a primary treatment for lymphoma but may be considered in specific cases.
Rated High Performing in Leukemia, Lymphoma & Myeloma
Schedule an AppointmentWithin Moffitt Cancer Center’s Malignant Hematology Program, each patient’s treatment plan is developed based on his or her needs and the unique dynamics of his or her cancer. Our state-of-the-art equipment enables us to focus on achieving the best patient outcomes and the highest quality of life.
Through ongoing research studies, we are continuing to learn more about how to prevent and treat lymphoma, always with a focus on improving patient outcomes and quality of life.
Chemotherapy for Lymphoma
Chemotherapy is often recommended for treating lymphoma for several important reasons. First, most types of lymphoma cells respond well to and can be destroyed by chemotherapy drugs. Additionally, because lymphoma develops in blood cells and circulates in the bloodstream to areas throughout the body, the condition is most effectively treated systemically. Even when the lymphoma appears to be confined to one area of the body, treatments like surgery and radiation therapy can leave some cancerous cells behind, simply due to the nature of the condition. As a systemic treatment, chemotherapy can reach and destroy cancerous cells in virtually every area of the body.
Chemotherapy can be very effective for treating lymphoma because it can stop cancerous cells from dividing and creating new abnormal cells. It can also trigger lymphoma cells to die prematurely (all cells in the body, including cancerous cells, have limited lifespans).
What Types of Chemotherapy Drugs are Used to Treat Hodgkin & Non-Hodgkin Lymphomas?
There are many different chemotherapy drugs that can be used for treating Hodgkin and non-Hodgkin lymphoma. The most appropriate drug or drug combination for a patient is determined based on several factors, including:
- The type of lymphoma
- Whether the lymphoma is fast growing (high grade) or slow growing (low grade)
- The affected areas of the body
- The symptoms the patient is experiencing
- The patient’s overall health condition
Possible Side Effects of Chemotherapy
Chemotherapy can cause side effects that vary depending on the type and dosage of chemotherapy drugs used, as well as the length of treatment. Some common side effects include:
- Nausea and vomiting
- Diarrhea or constipation
- Hair loss
- Mouth sores
- Decreased appetite
Some other side effects that can occur include fatigue and shortness of breath, an increased risk of infection, and a higher susceptibility to bleeding or bruising following minor injuries. Additionally, there are side effects that are specific to certain chemotherapy drugs.
Moffitt's lymphoma treatment team has ways to help patients manage side effects, if they are experienced. For instance, a medical oncologist may adjust dosage or drug type, and there are medications that can prevent or reduce nausea and vomiting.
Lymphoma Radiation Therapy
Radiation treatment is sometimes used to address lymphoma cells that have accumulated in a certain area of a patient’s body. In most cases, radiation treatment is combined with other therapies, such as chemotherapy, because lymphoma develops in white blood cells (lymphocytes) and tends to travel through the immune system instead of remaining in a single area of the body. Therefore, while targeted treatments like radiation therapy can be helpful for treating large masses and swollen lymph nodes, systemic treatment is usually necessary for both Hodgkin and non-Hodgkin lymphoma.
For these reasons, a combination of radiation therapy and chemotherapy is usually the preferred treatment approach for early-stage lymphoma. Through this type of multispecialty therapy, a patient can benefit from the targeted delivery of high-energy X-rays to shrink identifiable masses of lymphoma cells, as well as the systemic delivery of chemotherapy drugs to reach lymphoma cells located in distant areas throughout his or her body.
When is radiation therapy used to treat lymphoma?
The specific treatment regimen created for a patient, and whether or not it will include lymphoma radiation therapy, is determined based on several factors:
- The subtype and stage of the patient’s lymphoma
- Whether the condition is relapsed (after remission) or refractory (after initial treatment)
- A patient’s overall health condition, including any co-existing conditions like anemia, diabetes, or heart, lung, or kidney disease
- Whether a patient is pregnant
Surgery for Lymphoma
Although surgery can be used to help diagnose lymphoma (through biopsies), surgery is rarely used as a form of treatment. However, researchers have recently identified certain situations in which surgery may be a beneficial addition to a patient’s treatment plan, along with more traditional options, such as chemotherapy and radiation therapy.
One of the most promising possibilities for the use of surgery in lymphoma treatment is in the case of primary pulmonary lymphomas – especially those that develop in bronchus-associated lymphoid tissue (BALT). These tumors can sometimes be removed through surgical procedures, such as video-assisted thoracoscopy or open thoracoscopy.
Other diagnoses for which lymphoma surgery might be appropriate include:
- Splenic lymphomas – surgical removal of the spleen can help eliminate cancerous cells from the body
- Nodal marginal zone lymphomas – a small number of these cancers might be eligible for surgical resection
- Pediatric B-cell non-Hodgkin lymphomas – in some situations, a surgeon may recommend total removal of the tumors as an alternative to intensified chemotherapy, or may need to perform an emergency surgery in the case of sudden and serious complications
Surgery can also be used to help drain pleural effusions, which are buildups of fluid in the chest that often develop as a complication of non-Hodgkin lymphoma. However, these surgeries are not intended to treat the cancer itself, but rather to alleviate a specific symptom and improve a patient’s quality of life.
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Schedule an AppointmentImmunotherapy for Lymphoma
Immunotherapy is a type of treatment for lymphoma that boosts immune system function and helps it identify and destroy cancerous cells. Various types of immunotherapy have been studied and used for decades, but new therapies are constantly being developed and researched at Moffitt Cancer Center. Depending on a patient’s specific situation, immunotherapy may be used alone or in combination with other lymphoma treatment options. Both Hodgkin and non-Hodgkin lymphoma can be treated with immunotherapy.
When a Physician May Recommend Immunotherapy for Lymphoma
Whether—and when—a physician recommends immunotherapy for lymphoma treatment depends on the specific type of lymphoma, the stage of the disease and other factors. For some lymphomas, immunotherapies may be the first treatment. For other types, immunotherapies might be used in the case of a relapse (return of the disease after being considered cancer-free) or for refractory lymphomas (those that no longer respond to other treatments). There are over 70 types of lymphomas, so your oncology team will determine whether immunotherapy is the best course of treatment for your specific type.
How Effective is Immunotherapy for Treating Lymphoma?
Immunotherapy has been used to treat lymphoma for decades, and while it doesn’t work for every patient, it is effective in many cases. Almost all types of non-Hodgkin’s lymphomas are treated primarily with immunotherapies, while Hodgkin’s lymphomas are often treated in other ways first—patients may only receive immunotherapy if other options fail.
Types of Immunotherapy Used for Lymphoma Treatment
Several different types of immunotherapy are effective for treating lymphoma. These include:
Monoclonal Antibodies
These antibodies work by binding to proteins found on the surface of cancerous cells. There, they can block cell growth, help the immune system locate cancerous cells that need to be destroyed, or cause the cancerous cells to self-destruct. This was the first type of immunotherapy to be developed for lymphoma treatment, and one such drug (rituximab) is now considered to be a primary treatment option for B-cell lymphomas.
Immune Checkpoint Inhibitors
These inhibitors work by helping the body’s T cells (immune system cells) recognize and destroy cancerous cells that might otherwise go undetected. Normal cells have a protein checkpoint that bonds with a paired protein on T cells, signaling the T cells not to attack. Cancer cells can mimic these proteins to trick the immune system into thinking they are healthy cells, so they can avoid destruction. Inhibitors prevent these protein pairings from occurring so the T cells can correctly identify and attack lymphoma cells.
Cellular immunotherapy & CAR T-Cell Therapy
This treatment works by genetically modifying a patient’s own T cells so that they can more effectively recognize, target and destroy cancerous cells. One cellular immunotherapy option is chimeric antigen receptor (CAR) T cell therapy, which involves genetically modifying a patient’s T cells to improve the ability of the immune system to identify, target and destroy cancerous cells.
Therapeutic Cancer Vaccines
These vaccines work by training the immune system to recognize and attack cells that carry tumor-specific antigens. Some options are administered subcutaneously (under the skin) or intravenously (into a vein), while others are delivered directly to a tumor. Lymphoma vaccines are currently only available through clinical trials.
Side Effects of Lymphoma Immunotherapy Treatments
The side effects of immunotherapy for lymphoma depend on what therapy is delivered and what type of lymphoma is being treated, and can vary from person to person. Some people have significant side effects while others have none at all. However, some of the most common side effects of immunotherapy include:
- Fatigue
- Fever
- Chills
- Coughing
- Muscle, joint, and bone pain
- Headaches
- Nausea
- Vomiting
- Loss of appetite
- Diarrhea
- Constipation
- Skin rash
- Low blood cell counts
- Blood clots
- Nerve pain
- Dizziness
- Confusion
More serious side effects can also occur, including cytokine release syndrome (CRS), nervous system issues, and severe infections.
CAR T-Cell Therapy for Lymphoma
Chimeric antigen receptor (CAR) T-cell therapy is a highly specialized form of immunotherapy used to treat aggressive non-Hodgkin lymphoma and certain other cancers. Like bacteria and viruses, lymphoma acts as a harmful invader. However, cancer cells often develop complex features that allow them to evade detection by the immune system—the body’s natural defense against illness and infection. This evasion enables cancer to grow and form tumors unchecked.
CAR T-cell therapy helps overcome this challenge by genetically modifying a patient’s own white blood cells, known as T cells. These engineered cells are designed to better recognize, target, and destroy cancerous cells, enhancing the immune system’s ability to fight lymphoma.
Cell Therapy Experts
Moffitt's Blood & Marrow Transplant and Cellular Immunotherapy Program is recognized by FACT for meeting the highest standards for high-quality medical and laboratory practice in cellular therapies.
CAR T Therapy: How Moffitt is Continually Advancing Lymphoma Treatment
At Moffitt Cancer Center, our team is always investigating new treatments for lymphoma, including immunotherapies. As a National Cancer Institute-designated Comprehensive Cancer Center, we’re continually developing new ways to help the immune system recognize cancer cells and respond to them more effectively, giving patients a broader range of options for lymphoma treatment. For instance, we treated the first patient in the nation with KTE-C19 (a CAR T cell therapy) for aggressive non-Hodgkin lymphoma, and since then many more of our patients have benefited from this new therapy. This is just one example of our commitment to helping patients access cutting-edge therapies as soon as they become available.
Through extensive research performed in collaboration with cancer centers across the U.S., Moffitt has achieved several significant breakthroughs in CAR-T therapy for lymphoma, including the introduction and FDA approvals of:
- Yescarta™ – Approved by the FDA for treating aggressive, relapsed and/or refractory diffuse large B cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma and transformed follicular lymphoma. It is also approved for large B-cell lymphoma refractory or relapsing within 12 months of first-line therapy. Yescarta is also approved for relapsed/refractory follicular lymphoma after two lines of therapy.
- Kymriah™ – Approved by the FDA for treating relapsed or refractory large B-cell lymphoma, including DLBCL, high-grade B-cell lymphoma and DLBCL arising from follicular lymphoma. It is also approved for relapsed/refractory follicular lymphoma after two lines of therapy.
- BreyanziTM – Approved by the FDA for treating relapsed and/or refractory diffuse large B cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma and transformed indolent lymphoma. It is also approved for large B-cell lymphoma refractory or relapsing within 12 months of first-line therapy. Breyanzi is also approved for refractory or relapsed DLBCL patients for first-line therapy if they are ineligible for a transplant.
- Tecartus(R) – Approved by the FDA for the treatment of adult patients with relapsed/refractory mantle cell lymphoma (r/r MCL) when another treatment did not work, or the cancer returned after treatment.
Moffitt is proud to have been one of the first cancer centers in the nation to make these novel therapies available as a standard of care for many patients who are fighting lymphoma. Our commitment to research endures as we continue to investigate promising new immunotherapies and other treatment options, and we are making progress every day.
How Moffitt Leads the Way in Lymphoma Research and Comprehensive Cancer Care
Our researchers work diligently to develop new targeted therapeutics for lymphoma treatment. If a physician determines that a marrow or stem cell transplantation is indicated, these therapeutics and other treatment protocols can be integrated with our Blood and Marrow Transplant and Cellular Immunotherapy Program.
Moffitt is the only cancer center based in Florida to have received the prestigious designation of Comprehensive Cancer Center by the National Cancer Institute. Such centers are widely known as influential developers of clinical trials and more effective approaches to cancer diagnosis, treatment, and prevention. This designation allows us to attract some of the top physicians, specialists, and scientists from around the world – individuals who help us shape and deliver the top-notch care we give to every patient.
Lymphoma Treatment FAQs
Navigating a lymphoma diagnosis and understanding your treatment options can be overwhelming. As a national leader in cancer care, the experts at Moffitt Cancer Center have compiled answers to the most common questions our patients ask about Hodgkin and Non-Hodgkin lymphoma treatment. If you have complex or personal questions, please schedule a consultation with one of our specialists.
Learn More About the Moffitt Difference for Hodgkin and Non-Hodgkin Treatment
For more information about lymphoma treatment or to consult with one of our Hodgkin or non-Hodgkin lymphoma specialists, contact Moffitt Cancer Center by calling 1-888-519-0111 or by filling out our online form. No referral is necessary.
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