management

Last edited 05/2019

management

Treatment of NHL varies according to the the histologic type and stage of the disease.

  • asymptomatic patients with indolent forms of advanced NHL may require frequent and careful observation in order to initiate treatment when the clinical course of the disease accelerates
    • some patients may have a prolonged indolent while some may have more aggressive types of the disease which evolves rapidly and require immediate treatment
  •  radiation may be used for curative or palliative purposes and may be used alone or in combination with chemotherapy

Treatment can be divided into 2 broad categories:

  • indolent NHL
    • some examples of indolent NHL include - follicular lymphoma, lymphoplasmacytic lymphoma (Waldenström macroglobulinemia), marginal zone lymphoma, primary cutaneous anaplastic large cell lymphoma
    • standard treatment options include
      • local radiotherapy is the first-line treatment to people with localised stage IIA follicular lymphoma
      • watchful waiting for asymptomatic patients
      • Rituximab
      • Rituximab with chemotherapy
      • combination chemotherapy
      • palliative radiation therapy

  • aggressive NHL
    • increasingly seen in human immunodeficiency virus (HIV)-positive patients; 
    • examples of aggressive NHL include - diffuse large B-cell lymphoma, Burkitt's lymphoma, mantle cell lymphoma, follicular lymphoma, peripheral T cell lymphoma
    • standard treatment options include
      • R-CHOP = Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone.
      • other combination chemotherapy
      • radiation therapy
      • bone marrow or stem cell transplantation

Reference: