Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment for Aggressive, Stage I and Contiguous Stage II Adult NHL
Patients with stage I or contiguous stage II diffuse large B-cell lymphoma are candidates for combination chemotherapy with or without involved-field radiation therapy (IF-XRT).The following drug combinations are referred to in this section:R-CHOP: rituximab, an anti-CD20 monoclonal antibody, + cyclophosphamide + doxorubicin + vincristine + prednisone.Standard Treatment Options for Aggressive, Stage I and Contiguous Stage II Adult NHLStandard treatment options for aggressive, stage I and contiguous stage II adult NHL include the following:R-CHOP with or without IF-XRT.R-CHOP with or without IF-XRTFour prospective randomized trials have evaluated the comparison of CHOP or more intensive CHOP-based chemotherapy alone versus combined–modality therapy with CHOP and IF-XRT.[1,2,3,4,5]Evidence (CHOP vs. CHOP with IF-XRT): In a randomized trial with 7 years' median follow-up, 576 patients older than 60 years with early-stage disease received four cycles of CHOP with or without IF-XRT;
Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Recurrent Childhood Non-Hodgkin Lymphoma
Recurrent childhood non-Hodgkin lymphoma is cancer that has recurred (come back) after it has been treated. Childhood non-Hodgkin lymphoma may come back in the lymph system or in other parts of the body.
Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Childhood NHL
The most widely used staging scheme for childhood non-Hodgkin lymphoma (NHL) is that of the St. Jude Children's Research Hospital (Murphy Staging).Stage I Childhood NHLIn stage I childhood NHL, a single tumor or nodal area is involved, excluding the abdomen and mediastinum. Stage II Childhood NHLIn stage II childhood NHL, disease extent is limited to a single tumor with regional node involvement, two or more tumors or nodal areas involved on one side of the diaphragm, or a primary gastrointestinal tract tumor (completely resected) with or without regional node involvement. Stage III Childhood NHLIn stage III childhood NHL, tumors or involved lymph node areas occur on both sides of the diaphragm. Stage III NHL also includes any primary intrathoracic (mediastinal, pleural, or thymic) disease, extensive primary intra-abdominal disease, or any paraspinal or epidural tumors. Stage IV Childhood NHLIn stage IV childhood NHL, tumors involve bone marrow and/or central nervous system
Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Low-Stage Childhood NHL Treatment
Patients with stage I and II disease have an excellent prognosis, regardless of histology. A Children's Cancer Group study demonstrated that pulsed chemotherapy with cyclophosphamide, vincristine, methotrexate, and prednisone (COMP) administered for 6 months for low-stage (stage I or II) nonlymphoblastic non-Hodgkin lymphoma (NHL) was equivalent to 18 months of therapy with radiation to sites of disease, resulting in more than 85% disease-free survival (DFS) and more than 90% overall survival (OS). However, patients with lymphoblastic lymphoma had a much inferior outcome.[1,2] A Pediatric Oncology Group (POG) study tested 9 weeks of short, pulsed chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), with or without radiation to involved sites and with or without 24 weeks of maintenance chemotherapy. The results showed no benefit of radiation or maintenance chemotherapy, but the DFS for nonlymphoblastic lymphoma was superior to that of
Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Adult Non-Hodgkin Lymphoma (NHL)
The NHLs are a heterogeneous group of lymphoproliferative malignancies with differing patterns of behavior and responses to treatment.Like Hodgkin lymphoma, NHL usually originates in lymphoid tissues and can spread to other organs. NHL, however, is much less predictable than Hodgkin lymphoma and has a far greater predilection to disseminate to extranodal sites. The prognosis depends on the histologic type, stage, and treatment.Incidence and MortalityEstimated new cases and deaths from NHL in the United States in 2013:New cases: 69,740.Deaths: 19,020.AnatomyNHL usually originates in lymphoid tissues.Anatomy of the lymph system.Prognosis and SurvivalThe NHLs can be divided into two prognostic groups: the indolent lymphomas and the aggressive lymphomas. Indolent NHL types have a relatively good prognosis with a median survival as long as 10 to 20 years, but they usually are not curable in advanced clinical stages. Early-stage (stage I and stage II) indolent NHL can be effectively
Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - High-Stage Childhood Anaplastic Large Cell Lymphoma Treatment
Children and adolescents with high-stage (stage III or IV) anaplastic large cell lymphoma have a disease-free survival of approximately 60% to 75%.[1,2,3,4,5,6] It is unclear which strategy is best for the treatment of high-stage anaplastic large cell lymphoma. The German Berlin-Frankfurt-Munster (BFM) group used six cycles of intensive pulsed therapy, similar to their B-cell non-Hodgkin lymphoma (NHL) therapy (GER-GPOH-NHL-BFM-90 [NHL-BFM-90]).; [Level of evidence: 1iiA] Building on these results, the European Intergroup for Childhood NHL (EICNHL) group conducted the FRE-IGR-ALCL99 study (based on the GER-GPOH-NHL-BFM-90 regimen). First, this randomized study demonstrated that methotrexate 1 g/m2 infused over 24 hours plus intrathecal methotrexate and methotrexate 3 g/m2 infused over 3 hours without intrathecal methotrexate yielded similar outcomes.[Level of evidence: 1iiC] However, methotrexate 3 g/m2 over 3 hours had less toxicity than methotrexate 1 g/m2 over 24
Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Get More Information From NCI
Call 1-800-4-CANCERFor more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.Chat online The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer. Write to usFor more information from the NCI, please write to this address:NCI Public Inquiries Office9609 Medical Center Dr. Room 2E532 MSC 9760Bethesda, MD 20892-9760Search the NCI Web siteThe NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support
Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Non-Hodgkin Lymphoma During Pregnancy
General Information About NHL During PregnancyNon-Hodgkin lymphomas (NHLs) occur more frequently than Hodgkin lymphoma in an older population. This age difference may account for fewer reports of NHL in pregnant patients.Stage Information for NHL During PregnancyTo avoid exposure to ionizing radiation, magnetic resonance imaging is the preferred tool for staging evaluation. (Refer to the Stage Information for Adult NHL section of this summary for more information.)Treatment Option Overview for NHL During PregnancyTable 5. Treatment Options for NHL During PregnancyStageStandard Treatment OptionsIndolent NHL During PregnancyDelay treatment until after deliveryAggressive NHL During PregnancyImmediate therapyEarly delivery, when feasibleTermination of pregnancyIndolent NHL During PregnancyTreatment may be delayed for those women with an indolent NHL.Aggressive NHL During PregnancyImmediate therapyAccording to anecdotal case series, most NHLs in pregnant patients are aggressive,
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Bone Marrow Transplants
What to expect when you receive a bone marrow transplant.