Non-Hodgkin Lymphoma Chemotherapy: Performance, Adverse Effects, Further Details
Chemotherapy plays a crucial role in the treatment of Non-Hodgkin Lymphoma (NHL). Here's what you need to know about its duration, regimens, and side effects.
The typical treatment duration for chemotherapy in NHL is usually around four to six months, often administered in cycles of treatment followed by rest periods to allow recovery. For example, frontline chemotherapy for aggressive subtypes like diffuse large B-cell lymphoma commonly involves six cycles of a regimen such as R-CHOP, which includes drugs like cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab.
Each cycle consists of several anticancer drugs given either intravenously or orally over a set number of days, followed by a rest period—often a few weeks—before starting the next cycle. This cyclical administration balances delivering effective doses to kill cancer cells while allowing the patient's body time to recover from side effects.
First-line treatments for NHL may involve combinations of drugs from different groups, including CHOP, CVP, and R-CHOP. The cancer stage depends on the number of affected lymph nodes and how far the cancer has spread to other organs or bones.
Chemotherapy medications that doctors may prescribe for NHL include alkylating agents, corticosteroids, platinum drugs, purine analogs, anti-metabolites, anthracyclines, and other drugs. Depending on the drug, chemotherapy medications may have specific side effects such as nerve complications, bladder damage, heart failure, lung damage, and hypogammaglobulinemia.
Common short-term side effects of chemotherapy include hair loss, taste changes, mouth sores, nausea, vomiting, diarrhea, constipation, infections, bleeding, bruising easily, fatigue, and shortness of breath. High-grade NHL can grow and progress rapidly, but can be curable if treated early with chemotherapy. On the other hand, low-grade NHL is typically treated with conventional therapy, and may require intermittent treatment due to relapse.
In some cases, doctors may use a treatment called metronomic chemotherapy (mCHEMO), which involves a long-term, low dose administration of oral medication for NHL. This approach is designed to optimize treatment efficacy and tolerability.
It's important to note that depression is common in people with NHL undergoing chemotherapy. Medications can help reduce some side effects of chemotherapy, and doctors may use antiemetic drugs to manage chemotherapy-induced nausea and vomiting.
In some cases, chemotherapy may be administered directly into specific areas such as the abdomen, chest cavity, central nervous system, and urethra into the bladder to prevent cancer from spreading. Doctors may also use anticancer medication in the cerebrospinal fluid surrounding the brain (intrathecal chemotherapy) to prevent cancer from spreading to the brain.
People with NHL may be in remission for years, but may relapse multiple times. It's essential to discuss the potential risks and benefits of chemotherapy with your healthcare provider to make informed decisions about your treatment plan.
[1] American Cancer Society. (2021). Key Statistics for Non-Hodgkin Lymphoma. Retrieved from https://www.cancer.org/cancer/non-hodgkin-lymphoma/about/key-statistics.html [2] Mayo Clinic. (2021). Chemotherapy for Non-Hodgkin Lymphoma. Retrieved from https://www.mayoclinic.org/diseases-conditions/non-hodgkin-lymphoma/diagnosis-treatment/drc-20371213 [4] Leukemia & Lymphoma Society. (2021). R-CHOP Chemotherapy Regimen. Retrieved from https://www.lls.org/treatment/types-of-treatment/chemotherapy/r-chop-chemotherapy-regimen
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