Chemotherapy uses drugs to destroy cancer cells. The drugs enter the bloodstream and travel through the body. Chemotherapy primarily affects cancer cells but some healthy cells can also be damaged. The treatment plan and doses will be adjusted to provide the best effect against cancer with minimal side effects. Chemotherapy may be used on its own, but is more often used in combination with radiation therapy.
Chemotherapy may also be used in preparation for a bone marrow transplant, which may done for advanced or relapsed cases of non-Hodgkin lymphoma.
Chemotherapy Drugs and Delivery
There are a variety of chemotherapy drugs, but non-Hodgkin lymphoma is usually treated with specific regimens. The choice and combination of drugs is determined by the stage and type of lymphoma, as well as factors like your age and overall health. Examples of common chemotherapy drugs to treat non-Hodgkin lymphoma include:
- CHOP—cyclophosphamide, doxorubicin, vincristine, prednisone
- CVP—cyclophosphamide, vincristine, prednisone
- Cisplatin, carboplatin, oxaliplatin
Chemotherapy for non-Hodgkin lymphoma is usually given through an IV, but some forms can be given by mouth or directly into the cerebrospinal fluid. It is delivered in cycles over a set period of time. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best
Side Effects and Management
Though the drugs are targeted to cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:
- Nausea and vomiting
- Hair loss
- Reduced blood cell counts, which can lead to anemia or problems with blood clotting
- Bone marrow suppression and/or reduced white blood cell counts, which increases the risk of infection
- Inflammation and sores in the mouth, throat, or esophagus
- Infertility, and/or reproductive and sexual problems—If you plan on having children, talk to your doctor about options to preserve fertility before starting treatment. This also applies to adolescents who have gone through puberty.
A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort. Long-term side effects can include damage to the heart, peripheral nerves, kidneys, lungs, and some cognitive dysfunction.
Adult non-Hodgkin lymphoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/lymphoma/patient/adult-nhl-treatment-pdq. Accessed January 28, 2021.
Chemotherapy and drug therapy. Leukemia & Lymphoma Society website. Available at: http://www.lls.org/lymphoma/non-hodgkin-lymphoma/treatment/chemotherapy-and-drug-therapy. Accessed January 28, 2021.
Chemotherapy for non-Hodgkin lymphoma. American Cancer Society website. Available at: https://www.cancer.org/cancer/non-hodgkin-lymphoma/treating/chemotherapy.html. Accessed January 28, 2021.
Non-Hodgkin lymphoma (NHL). EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T116014/Non-Hodgkin-lymphoma-NHL. Accessed January 28, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 1/28/2021