What is included in the standard of care for non-Hodgkin lymphoma (NHL)?

Updated: Feb 25, 2021
  • Author: Sanjay Vinjamaram, MD, MPH; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The treatment of NHL varies greatly, depending on various factors. Common therapies include the following:

  • Chemotherapy: Most common; usually combination regimens
  • Biologic agents (eg, rituximab, obinutuzumab, lenalidomide): Typically in combination with chemotherapy
  • Radiation therapy
  • Bone marrow transplantation: Possible role in relapsed high-risk disease
  • Chimeric antigen receptor (CAR) T-cell therapy: In relapsed or refractory large B-cell lymphoma
  • Radioimmunotherapy
  • Transfusions of blood products
  • Antibiotics

Pharmacotherapy

Medications used in the management of NHL include the following:

  • Cytotoxic agents (eg, chlorambucil, cyclophosphamide, doxorubicin, vincristine, fludarabine, pralatrexate, nelarabine, etoposide, mitoxantrone, cytarabine, bendamustine, carboplatin, cisplatin, gemcitabine, denileukin diftitox, bleomycin)

  • Histone deacetylase inhibitors (eg, vorinostat, romidepsin, belinostat)

  • Colony-stimulating factor growth factors (eg, epoetin alfa, darbepoetin alfa, filgrastim, pegfilgrastim)

  • Monoclonal antibodies (eg, rituximab, ibritumomab tiuxetan, alemtuzumab, ofatumumab, obinutuzumab, pembrolizumab)

  • mTOR (mammalian target of rapamycin) kinase inhibitors (eg, temsirolimus)

  • Proteasome inhibitors (eg, bortezomib)

  • Immunomodulators (eg, interferon alfa-2a or alfa-2b)

  • Corticosteroids (eg, dexamethasone, prednisone)

Surgery

Surgical intervention in NHL is limited but can be useful in selected situations (eg, GI lymphoma), particularly in localized disease or in the presence of risk of perforation, obstruction, and massive bleeding. Orchiectomy is part of the initial management of testicular lymphoma.

See Treatment and Medication for more detail.


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