A number of treatments are used for non-Hodgkin lymphoma. Treatment plans are tailored to the specific type of non-hodgkin lymphoma and its stage. Not all patients will need all of these treatments, but it is important to know that most forms of non-hodgkin lymphoma in children cannot be cured with surgery alone.
Chemotherapy is the standard treatment for non-Hodgkin lymphoma. Chemotherapy works by interfering with the ability of cancer cells to divide and duplicate themselves. Chemotherapy can be given through the bloodstream to reach cancer cells all over the body, or it can be delivered directly to specific cancer sites. For non-Hodgkin lymphoma, chemotherapy can be given by mouth or through a needle into the vein or muscle. The drugs go into the bloodstream so that they reach all parts of the body (systemic) to kill cancer cells throughout the body.
Radiation therapy uses high-energy rays to kill cancer cells. Radiation is occasionally used in emergent situations but is rarely needed in the overall therapy of children with non-Hodgkin lymphoma.
High Dose Chemotherapy or Radiation Therapy with Stem Cell Transplantation
If the lymphoma comes back after successful treatment (relapse) or if the lymphoma does not respond to conventional treatments (refractory), higher dose chemotherapy with or without radiation followed by a stem cell transplant (rescue) may offer the best chance of cure. There are two types of transplant, autologous (self) or allogeneic (another human donor) and the type used will depend on the specific type of lymphoma and other factors.
Monoclonal Antibody Therapy
Monoclonal antibody therapy uses antibodies (proteins) made in a laboratory, which are able to recognize specific cancer cells by special “markers” on the cells. The antibodies attach to these markers, causing the cancer cells to die or preventing them from multiplying. Monoclonal antibodies are given intravenously in the same way chemotherapy is given. The use of monoclonal antibodies is being evaluated for effectiveness when used in conjunction with chemotherapy. One monoclonal antibody that has proven useful in the treatment of non-Hodgkin lymphoma in pediatric and adult patients is rituximab.