Contents
1. What are the treatment modalities for lymphoma?
2. What are the chemotherapy regimens for lymphoma?
3. What are the limitations of chemotherapy for lymphoma?
4. For whom is radiotherapy suitable?
5.What are the limitations of radiotherapy for lymphoma?
6.What are the other treatment options for lymphoma?
I. What are the treatment methods for lymphoma?
Your doctor may choose the appropriate treatment plan for you according to the type of tumor and overall condition, including chemotherapy, radiotherapy, bone marrow or hematopoietic stem cell transplantation, surgery and biologic therapy.
Combination treatment is better than single treatment because each means of treatment works differently, some work this way and some work that way. This is just like fighting a war, we need to fight with multiple types of soldiers, artillery has the role of artillery, rifle has the use of rifle, and joint cooperation can bring greater benefits. It is the same reason for tumor fighting, and integrated treatment can destroy lymphoma cells to the maximum.
Second, what are the chemotherapy regimens for lymphoma?
Chemotherapy is a treatment modality that uses chemical drugs to kill tumor cells, inhibit the growth and reproduction of tumor cells and promote the differentiation of tumor cells. During the past 30 years of treatment, doctors have concluded some chemotherapy regimens with definite efficacy, which are one of the important tools for lymphoma.
In the treatment of Hodgkin’s lymphoma, the ABVD regimen is preferred (adriamycin, bleomycin, vincristine, azulenimide), in addition to the commonly used MOPP regimen (nitrogen mustard, vincristine, methylbenzylhydrazine, prednisone).
In the treatment of non-Hodgkin’s lymphoma, the CHOP (cyclophosphamide, adriamycin, vincristine, pedialyte, prednisone) regimen is commonly used.
What are the limitations of chemotherapy for lymphoma?
The limitations of chemotherapy are caused by its non-specific cytotoxicity, which is commonly referred to as “enemy-versus-us”.
The efficacy of chemotherapeutic drugs on lymphoma cells is based on the characteristics that these cells differentiate and multiply faster than normal cells, so it is inevitable that they will damage some normal cells that also differentiate and multiply faster, causing various adverse reactions, such as damage to hair follicle cells, which will cause hair loss; damage to hematopoietic cells in the bone marrow, which will cause a decrease in white blood cells and platelets; damage to mucosal cells in the gastrointestinal tract, which will cause nausea and vomiting. If the mucous membrane cells of the gastrointestinal tract are damaged, nausea and vomiting will easily occur. These adverse reactions not only affect the quality of life of patients, but also cause interruption of the treatment plan in serious cases, which is extremely detrimental to the treatment and recovery of lymphoma.
Which lymphoma patients are suitable for radiotherapy?
Radiotherapy is the primary treatment for stage I and II Hodgkin’s lymphoma and for low-grade malignant stage I and II non-Hodgkin’s lymphoma.
There are four types of radiotherapy: irradiation of the involved site, expanded site and secondary whole lymph nodes or whole body lymph nodes.
In addition to the involved lymph nodes and tumor tissues, the expanded irradiation must also include the nearby lymph node areas that may be invaded. If the lesion is above the diaphragm, the cloak is used, and below the diaphragm, the inverted “Y” or combined hoe is used.
Whole-body lymph node irradiation includes cloak, hoe and inverted “Y”.
What are the limitations of radiotherapy for lymphoma?
The limitations of radiation therapy are threefold.
First, for Hodgkin’s lymphoma, radiotherapy alone is only applicable to stage I and II lesions; for stage III and IV lesions, radiotherapy alone cannot achieve radical cure.
Secondly, for non-Hodgkin’s lymphoma, since the pathway of spread is not through the lymphatic area, the efficiency of large irregular irradiation fields in the form of cape, hoe and inverted “Y” is poor and the recurrence rate is high.
Finally, radiation therapy does not only target lymphoma cells, but also kills normal cells in the irradiated area, so it can often be very traumatic for patients.
What are the other treatment methods for lymphoma?
(a) Bone marrow or hematopoietic stem cell transplantation
Hematopoietic stem cell transplantation is a procedure that pre-treats lymphoma patients with intense radiotherapy and chemotherapy to kill the maximum number of cancer cells in the patient’s body, and then implants hematopoietic stem cells into the body to restore their hematopoietic and immune functions.
The currently available hematopoietic stem cells are mainly derived from bone marrow, peripheral blood or fetal umbilical cord blood from fonts or allogeneic (siblings or unrelated donors who meet the matching requirements).
In the treatment of lymphoma, autologous peripheral blood hematopoietic stem cell transplantation, or autologous bone marrow transplantation is most commonly used, and a few patients may be considered for treatment with allogeneic hematopoietic stem cell transplantation.
Stem cell transplantation is a means of treating lymphoma, but not all patients will be successful, and about 30% will fail in treatment. The main reasons for failure are advanced stage, primary tumor resistance, high tumor load before transplantation or high malignancy. After stem cell transplantation, there is still a certain chance of recurrence and other treatment-related risks. Therefore, it is necessary for doctors and patients to communicate well and consider carefully to choose the effective treatment timing.
(ii) Surgical treatment
If hypersplenism is indicated, resection is feasible to improve the blood picture and create favorable conditions for future chemotherapy.
(C) Biological treatment of lymphoma
At present, the medical community considers the following three drugs available for biological treatment of lymphoma.
Monoclonal antibodies: all CD20-positive B-cell lymphomas can be treated with CD20 monoclonal antibody melphalan (rituximab). Moreover, B-cell lymphoma can greatly improve the efficacy of transplantation treatment by using melova (rituximab) to do in vivo tumor cell purification before hematopoietic stem cell transplantation. Meroval (rituximab) is the world’s first monoclonal antibody approved for clinical use in the treatment of non-Hodgkin’s lymphoma (NHL).
Interferon: Partial palliation in mycosis fungoides and follicular small cleaved cell type lymphoma.
Anti-H. pylori drugs: lymphomas in the marginal zone of the mucosa-associated lymphoma tissue outside the gastric nodes can be improved and the lymphomas disappear in some patients after anti-H. pylori treatment.
This article is authorized by Dr. Bing Chen.
Contents
1. What are the treatment modalities of lymphoma?
2. What are the chemotherapy regimens for lymphoma?
3. What are the limitations of chemotherapy for lymphoma?
4. For which lymphoma patients is radiotherapy suitable?
5.What are the limitations of radiotherapy for lymphoma?
6.What are the other treatment options for lymphoma?
I. What are the treatment methods for lymphoma?
Your doctor may choose the appropriate treatment plan for you according to the type of tumor and overall condition, including chemotherapy, radiotherapy, bone marrow or hematopoietic stem cell transplantation, surgery and biologic therapy.
Combination treatment is better than single treatment because each means of treatment works differently, some work this way and some work that way. This is just like fighting a war, we need to fight with multiple types of soldiers, artillery has the role of artillery, rifle has the use of rifle, and joint cooperation can bring greater benefits. It is the same reason for tumor fighting, and integrated treatment can destroy lymphoma cells to the maximum.
Second, what are the chemotherapy regimens for lymphoma?
Chemotherapy is a treatment modality that uses chemical drugs to kill tumor cells, inhibit the growth and reproduction of tumor cells and promote the differentiation of tumor cells. During the past 30 years of treatment, doctors have concluded some chemotherapy regimens with definite efficacy, which are one of the important tools for lymphoma.
In the treatment of Hodgkin’s lymphoma, the ABVD regimen is preferred (adriamycin, bleomycin, vincristine, azulenimide), in addition to the commonly used MOPP regimen (nitrogen mustard, vincristine, methylbenzylhydrazine, prednisone).
In the treatment of non-Hodgkin’s lymphoma, the CHOP (cyclophosphamide, adriamycin, vincristine, pedialyte, prednisone) regimen is commonly used.
What are the limitations of chemotherapy for lymphoma?
The limitations of chemotherapy are caused by its non-specific cytotoxicity, which is commonly referred to as “enemy-versus-us”.
The efficacy of chemotherapeutic drugs on lymphoma cells is based on the characteristics that these cells differentiate and multiply faster than normal cells, so it is inevitable that they will damage some normal cells that also differentiate and multiply faster, causing various adverse reactions, such as damage to hair follicle cells, which will cause hair loss; damage to hematopoietic cells in the bone marrow, which will cause a decrease in white blood cells and platelets; damage to mucosal cells in the gastrointestinal tract, which will cause nausea and vomiting. If the mucous membrane cells of the gastrointestinal tract are damaged, nausea and vomiting will easily occur. These adverse reactions not only affect the quality of life of patients, but also cause interruption of the treatment plan in serious cases, which is extremely detrimental to the treatment and recovery of lymphoma.
Which lymphoma patients are suitable for radiotherapy?
Radiotherapy is the primary treatment for stage I and II Hodgkin’s lymphoma and for low-grade malignant stage I and II non-Hodgkin’s lymphoma.
There are four types of radiotherapy: irradiation of the involved site, expanded site and secondary whole lymph nodes or whole body lymph nodes.
In addition to the involved lymph nodes and tumor tissues, the expanded irradiation must also include the nearby lymph node areas that may be invaded. If the lesion is above the diaphragm, the cloak is used, and below the diaphragm, the inverted “Y” or combined hoe is used.
Whole-body lymph node irradiation includes cloak, hoe and inverted “Y”.
What are the limitations of radiotherapy for lymphoma?
The limitations of radiation therapy are threefold.
First, for Hodgkin’s lymphoma, radiotherapy alone is only applicable to stage I and II lesions; for stage III and IV lesions, radiotherapy alone cannot achieve radical cure.
Secondly, for non-Hodgkin’s lymphoma, since the pathway of spread is not through the lymphatic area, the efficiency of large irregular irradiation fields in the form of cape, hoe and inverted “Y” is poor and the recurrence rate is high.
Finally, radiation therapy does not only target lymphoma cells, but also kills normal cells in the irradiated area, so it can often be very traumatic for patients.
What are the other treatment methods for lymphoma?
(a) Bone marrow or hematopoietic stem cell transplantation
Hematopoietic stem cell transplantation is a procedure that pre-treats lymphoma patients with intense radiotherapy and chemotherapy to kill the maximum number of cancer cells in the patient’s body, and then implants hematopoietic stem cells into the body to restore their hematopoietic and immune functions.
The currently available hematopoietic stem cells are mainly derived from bone marrow, peripheral blood or fetal umbilical cord blood from fonts or allogeneic (siblings or unrelated donors who meet the matching requirements).
In the treatment of lymphoma, autologous peripheral blood hematopoietic stem cell transplantation, or autologous bone marrow transplantation is most commonly used, and a few patients may be considered for treatment with allogeneic hematopoietic stem cell transplantation.
Stem cell transplantation is a means of treating lymphoma, but not all patients will be successful, and about 30% will fail in treatment. The main reasons for failure are advanced stage, primary tumor resistance, high tumor load before transplantation or high malignancy. After stem cell transplantation, there is still a certain chance of recurrence and other treatment-related risks. Therefore, it is necessary for doctors and patients to communicate well and consider carefully to choose the effective treatment timing.
(ii) Surgical treatment
If hypersplenism is indicated, resection is feasible to improve the blood picture and create favorable conditions for future chemotherapy.
(C) Biological treatment of lymphoma
At present, the medical community considers the following three drugs available for biological treatment of lymphoma.
Monoclonal antibodies: all CD20-positive B-cell lymphomas can be treated with CD20 monoclonal antibody melphalan (rituximab). Moreover, B-cell lymphoma can greatly improve the efficacy of transplantation treatment by using melova (rituximab) to do in vivo tumor cell purification before hematopoietic stem cell transplantation. Meroval (rituximab) is the world’s first monoclonal antibody approved for clinical use in the treatment of non-Hodgkin’s lymphoma (NHL).
Interferon: Partial palliation in mycosis fungoides and follicular small cleaved cell type lymphoma.
Anti-H. pylori drugs: lymphomas in the marginal bands of mucosa-associated lymphoma tissue outside the gastric nodes can be improved and the lymphomas disappear in some patients after anti-H. pylori treatment.