Overview

Lymphoma is a form of cancer that affects the lymph system. This system includes the:

  • lymph nodes
  • thymus
  • spleen
  • bone marrow
  • tonsils
  • lymph fluid

While many types of lymphoma exist, doctors divide them into two categories. These are Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma (NHL).

People with Hodgkin’s lymphoma have cells known as Reed-Sternberg cells. Those with NHL don’t have these cell types. Both lymphoma forms can cause similar symptoms.

Treatments for either form of lymphoma depend on the specific cells affected and the cancer type. In addition to radiation treatments to kill cancerous cells and shrink tumors, doctors often prescribe medications that treat the cancerous cells or the lymphoma symptoms.

Chemotherapy drugs are medications used alone or in combination to target lymphoma cells. These drugs kill cancer cells or keep them from multiplying. Chemotherapy medications can treat Hodgkin’s lymphoma.

Chemotherapy medications often involve combining several drugs together for optimum results. Doctors give the medications via an intravenous (IV) treatment. Special IV lines called a port or port-a-cath are used to deliver these medications. The port provides access to a large vein, usually in the chest. This prevents vein damage from the strong medications.

Three chief chemotherapy regimens for Hodgkin’s lymphoma exist.

ABVD includes the following drugs:

  • doxorubicin (Adriamycin)
  • bleomycin (Blenoxane)
  • vinblastine (Velban)
  • dacarbazine (DTIC-Dome)

BEACOPP includes the following drugs:

  • bleomycin (Blenoxane)
  • etoposide (Etopophos, Toposar, VePesid, VP-16)
  • doxorubicin (Adriamycin)
  • cyclophosphamide (Cytoxan)
  • vincristine (Oncovin)
  • procarbazine (Matulane)
  • prednisone (Rayos, Prednisone Intensol)

Stanford V includes the following drugs:

  • mechlorethamine (Mustargen)
  • doxorubicin (Adriamycin)
  • vinblastine (Velban)
  • vincristine (Oncovin)
  • bleomycin (Blenoxane)
  • etoposide (Etopophos, Toposar, VePesid, VP-16)
  • prednisone (Rayos, Prednisone Intensol)

Doctors prescribe the Stanford V regimen to people with advanced lymphoma. Doctors are more likely to prescribe the ABVD regimen for earlier stages.

Doctors prescribe chemotherapy to treat NHL, as well. Similar to drugs used for Hodgkin’s lymphoma treatments, pharmacists mix several chemotherapy medications together. These medication types fall into six categories. Doctors select a medication based on the lymphoma type and stage.

Alkylating agents

These drugs keep cells from replicating by destroying DNA. While effective, they’re associated with an increased risk for leukemia. Examples include:

  • cyclophosphamide (Cytotoxan)
  • chlorambucil (Leukeran)
  • bendamustine (Treanda)
  • ifosfamide (Ifex)

Corticosteroids

Corticosteroids kill cancerous cells, prevent the cancerous cells from growing, and can reduce nausea. Examples of these medications include:

  • prednisone (Rayos, Prednisone Intensol)

Platinum drugs

Platinum drugs work similarly to alkylating agents, but they don’t pose an increased risk for leukemia. Examples of these drugs include:

  • carboplatin (Paraplatin)
  • cisplatin (Platinol)
  • oxaliplatin (Eloxatin)

Purine analogs

Purine analogs reduce cell metabolism to keep cancerous cells from reproducing and dividing. Medication examples include:

  • cladribine (2-CdA, Leustatin)
  • fludarabine (Fludera)
  • pentostatin (Nipent)

Antimetabolites

These drugs prevent DNA and RNA from growing and killing the cancerous cells. Examples include:

  • capecitabine (Xeloda)
  • cytarabine (ara-C)
  • gemcitabine (Gemzar)
  • methotrexate (Trexall)
  • pralatrexate (Folotyn)

Additional medications

Additional medications used to treat lymphoma that don’t fit into a particular category include:

  • bleomycin (Blenoxane)
  • doxorubicin (Adriamycin)
  • etoposide (Etopophos, Toposar, VePesid, VP-16)
  • mitoxantone (Novantrone)
  • vincristine (Oncovin)

According to the American Cancer Society (ACS), CHOP is a common NHL chemotherapy regimen. Pharmacists combine the following drugs:

  • cyclophosphamide (Cytotxan)
  • doxorubicin (hydroxydoxorubicin)
  • vincristine (Oncovin)
  • prednisone (Rayos, Prednisone Intensol)

Doctors may add rituximab (Rituxan) to this regimen, which is known as R-CHOP. According to the Leukemia & Lymphoma Society (LLS), the R-CHOP regimen treats more aggressive forms of NHL. This method can cure NHL in some people.

The combination of cyclophosphamide, vincristine, and prednisone (CVP) is another regimen.

Immunotherapy can boost the body’s immune system to fight cancer in people with NHL. In addition to fighting cancer, immunotherapy drugs can minimize some of chemotherapy’s side effects, including nausea and fatigue.

These medications are often called guided missiles. They specifically target cancer cells. Other chemotherapy medications can harm healthy cells that multiply quickly, such as hair cells.

Immunotherapy medications that treat NHL include:

  • immune modulators, including thalidomide (Thalomid) and lenalidomide (Revlimid)
  • monoclonal antibodies, such as rituximab (Rituxan)
  • proteasome inhibitors, such as bortezomib (Velcade)
  • small molecule treatments, such as panobinostat (Farydak)

A doctor may prescribe these or other treatments, depending upon the person’s NHL type.