Lymphomas

Common Forms of Lymphoma

Following are many variations of lymphoma, along with typical characteristics and treatment options. Common treatments are listed, but options may depend on the stage of your cancer, your treatment history and your general health. Talk with your doctor about the option that might be best for you. Additionally, ask your doctor if you are a candidate for clinical trials, which offer access to new therapies and regimens that are currently being evaluated.

 

Cancer Type Description Treatment
Non-Hodgkin Lymphoma (NHL)
B-cell lymphomas (NHLs)
Diffuse large B-cell lymphoma (DLBCL) • Most common type of NHL   in adults in the United   States (about 1 of every 3   cases)
• Fast-growing
• Average age at diagnosis,   mid-60s
• R-CHOP: rituximab (Rituxan), cyclophosphamide,   doxorubicin (Adriamycin), vincristine (Oncovin) and   prednisone
• EPOCH-R: etoposide (Etopophos), prednisone, vincristine   (Oncovin), cyclophosphamide and doxorubicin (Adriamycin)   + rituximab (Rituxan)
• Immunotherapy: axicabtagene ciloleucel (Yescarta),   rituximab (Rituxan), rituximab and hyaluronase human   (Rituxan Hycela)
• High-dose chemotherapy and stem cell transplantation
Primary mediastinal B-cell lymphoma (subtype of DLBCL) • Most likely to occur in   women in their 30s
• Fast-growing but typically   responds well to treatment
• R-CHOP: rituximab (Rituxan), cyclophosphamide,   doxorubicin (Adriamycin), vincristine (Oncovin) and   prednisone
• EPOCH-R: etoposide (Etopophos), prednisone, vincristine   (Oncovin), cyclophosphamide and doxorubicin   (Adriamycin) + rituximab (Rituxan)
• Immunotherapy: rituximab (Rituxan)
• High-dose chemotherapy and stem cell transplantation
Intravascular large B-cell lymphoma (subtype of DLBCL) • Rare
• Lymphoma cells found   only inside blood vessels
• R-CHOP: rituximab (Rituxan), cyclophosphamide,   doxorubicin (Adriamycin), vincristine (Oncovin) and   prednisone
• EPOCH-R: etoposide (Etopophos), prednisone, vincristine   (Oncovin), cyclophosphamide and doxorubicin (Adriamycin)   + rituximab (Rituxan)
• Immunotherapy: rituximab (Rituxan)
• High-dose chemotherapy and stem cell transplantation
Follicular lymphoma • Slow-growing and   responds well to treatment   but hard to cure
• Found in lymph node sites   and bone marrow
• Called follicular for the   circular pattern in which   the cancer cells grow in   the lymph nodes
• Average age at diagnosis,   60
• BR: bendamustine (Bendeka, Treanda) + rituximab   (Rituxan)
• R-CHOP: rituximab (Rituxan), cyclophosphamide,   doxorubicin (Adriamycin), vincristine (Oncovin) and   prednisone
• Bendamustine (Bendeka, Treanda) and lenalidomide   (Revlimid)
• R-CVP: rituximab (Rituxan), cyclophosphamide, vincristine   (Oncovin) and prednisone
• Chemotherapy: chlorambucil (Leukeran)
• Immunotherapy: obinutuzumab (Gazyva), rituximab   (Rituxan), rituximab and hyaluronidase human (Rituxan   Hycela)
• Radioimmunotherapy: ibritumomab (Zevalin)
• High-dose chemotherapy and stem cell transplantation
• Targeted therapy: copanlisib (Aliqopa), idelalisib (Zydelig)
• Radiation therapy
• Watchful waiting (for indolent [slow-growing] disease)
Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) • CLL cancer cells found   mainly in blood and bone   marrow
• SLL cancer cells found   mainly in lymph nodes and   spleen
• Slow-growing
• Chemotherapy: bendamustine (Bendeka, Treanda),   chlorambucil (Leukeran), cyclophosphamide, doxorubicin,   fludarabine, mechlorethamine (Mustargen), methotrexate   (Trexall), venetoclax (Venclexta), vincristine
• Immunotherapy: alemtuzumab (Campath, Lemtrada),   obinutuzumab (Gazyva), ofatumumab (Arzerra), rituximab   (Rituxan), rituximab and hyaluronidase human (Rituxan   Hycela)
• Targeted therapy: ibrutinib (Imbruvica), idelalisib (Zydelig)
• Radiation therapy
• Watchful waiting
 
Mantle cell lymphoma •Affects more men than   women
•Average age at diagnosis,   early 60s
•Usually found in lymph   nodes, bone marrow and   spleen
•Hyper-CVAD: cyclophosphamide, vincristine (Oncovin),   doxorubicin (Adriamycin) and dexamethasone, alternating   with high-dose methotrexate (Trexall) plus cytarabine +   rituximab (Rituxan)
•R-CHOP: rituximab (Rituxan), cyclophosphamide,   doxorubicin (Adriamycin), vincristine (Oncovin) and   prednisone
•BR: bendamustine (Treanda) + rituximab (Rituxan)
•Immunotherapy: lenalidomide (Revlimid), rituximab   (Rituxan)
•High-dose chemotherapy and stem cell transplantation
Marginal zone B-cell lymphomas •Cells look small under a   microscope
•Three subtypes:
   1. Extranodal (also known        as mucosa-associated        lymphoid tissue [MALT]        lymphomas)
   2. Nodal
   3. Splenic
Extranodal (MALT)
•R-CHOP: rituximab (Rituxan), cyclophosphamide,   doxorubicin (Adriamycin), vincristine (Oncovin) and   prednisone
•CVP: cyclophosphamide, vincristine (Oncovin), prednisone
•BR: bendamustine (Treanda) + rituximab (Rituxan)
•Chemotherapy: chlorambucil (Leukeran), fludarabine
•Immunotherapy: rituximab (Rituxan)
•Antibiotics
•Radiation therapy
•Surgery
•Targeted therapy: ibrutinib (Imbruvica)
 
Nodal
•Watchful waiting
•Radiation therapy
•Chemotherapy
 
Splenic
•Surgery
•Radiation therapy
•Immunotherapy
•Chemotherapy
Burkitt lymphoma •Rare and fast-growing •Nearly 90% of patients are   male
•Average age at diagnosis,   30
Intensive chemotherapy and treatment for the central nervous system to prevent metastasis to the brain:

•Hyper-CVAD: cyclophosphamide, vincristine (Oncovin),   doxorubicin (Adriamycin) and dexamethasone, alternating   with high-dose methotrexate (Trexall) and cytarabine +   rituximab (Rituxan)
•CODOX-M/IVAC: cyclophosphamide, vincristine (Oncovin),   doxorubicin (Adriamycin) and intrathecal methotrexate   (Trexall), and cytarabine followed by high-dose systemic   methotrexate + rituximab (Rituxan)
•EPOCH-R: etoposide (Etopophos), prednisone, vincristine   (Oncovin), cyclophosphamide and doxorubicin   (Adriamycin) + rituximab (Rituxan)
Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia) •Rare
•Found mainly in bone   marrow, lymph nodes and   spleen
•Chemotherapy
•Immunotherapy: rituximab (Rituxan)
•Radiation therapy
•Targeted therapy: ibrutinib (Imbruvica)
•Watchful waiting
•High-dose chemotherapy and stem cell transplantation
•Plasma exchange
Hairy cell leukemia •Rare and slow-growing
•Can be considered a   lymphoma despite its   name
•More common in men
•Average age at diagnosis,   50
•Watchful waiting
•Chemotherapy: chlorambucil (Leukeran), cladribine   (Leustatin), pentostatin (Nipent), prednisone
•Immunotherapy: interferon alfa, rituximab (Rituxan)
Primary central nervous system (CNS) lymphoma •Usually involves the brain   but may also be found in   the spinal cord and in   tissues around the spinal   cord and eye
•Rare, but more common in   people with immune   system problems
•Radiation therapy
•Chemotherapy: cytarabine, methotrexate (Trexall)
•Immunotherapy: rituximab (Rituxan)
•Corticosteroids
•High-dose chemotherapy and stem cell transplantation
T-cell lymphomas (NHLs)
Precursor T-lymphoblastic lymphoma/leukemia •Can be considered a   leukemia or lymphoma,   depending on how much   bone marrow is involved
•Most often affects young   adults (men more than   women)
•Fast-growing
•Often starts in the thymus   gland, where T-cells are   made
•Chemotherapy
Peripheral T-cell lymphomas •Rare
•Develop from mature forms   of T-cells
•Many subtypes
•CHOP: cyclophosphamide, doxorubicin (Adriamycin),   vincristine (Oncovin) and prednisone
•Chemotherapy: belinostat (Beleodaq), pralatrexate   (Folotyn)
•Radiation therapy
•High-dose chemotherapy and stem cell transplantation
•Targeted therapy
Cutaneous T-cell lymphomas •Start in the skin Skin-directed treatments:
•Radiation therapy
•Phototherapy
•Topical medicines

Systemic treatments:
•Photopheresis
•Chemotherapy
•Targeted therapy
•High-dose chemotherapy and stem cell transplantation
Adult T-cell leukemia/lymphoma •Rare in the United States
•Caused by an infection   with the HTLV-1 virus,   commonly found in Japan,   the Caribbean and Africa
•Four subtypes: smoldering,   chronic, acute and   lymphoma
•Immunotherapy: interferon alfa
•Chemotherapy: cyclophosphamide, doxorubicin   hydrochloride, prednisone, vincristine sulfate
•High-dose chemotherapy and stem cell transplantation
Angioimmunoblastic T-cell lymphoma •More common in older   adults
•Involves lymph nodes,   spleen or liver
•Fast-growing
•Corticosteroids
•Chemotherapy
•High-dose chemotherapy and stem cell transplantation
Extranodal natural killer/T-cell lymphoma, nasal type •Rare
•Often involves upper   airway passages but can   invade the skin and   digestive tract
•Most common in parts of   Asia and South America
•Chemotherapy
•Radiation therapy
Enteropathy-associated intestinal T-cell lymphoma (EATL) •Rare and fast-growing
•Occurs in lining of the   intestine
•Can cause a blockage or   hole in the intestine
•Two subtypes:
   1. Type 1 occurs in       people with celiac       disease, celiac sprue
      or sprue
   2. Type 2 (less common       than Type 1) is not       linked to sprue and       the cells looks different       under the microscope
•Surgery
•Chemotherapy
•High-dose chemotherapy and stem cell transplantation
Anaplastic large cell lymphoma (ALCL) •More common in young   people, but does occur in   people in their 50s and   60s
•Usually starts in lymph   nodes
•Can spread to skin
•Fast-growing but curable
•Two subtypes:
   1. Primary cutaneous
   2. Systemic
• Radiation therapy
• Chemotherapy
• High-dose chemotherapy and stem cell transplantation
• Targeted therapy: brentuximab vedotin (Adcetris)
Peripheral T-cell lymphoma, unspecified • Involves lymph nodes but   can affect skin, bone   marrow, liver and GI tract
• Fast-growing
• Average age at diagnosis,   60s
• Includes several subtypes
• CHOP: cyclophosphamide, doxorubicin (Adriamycin),   vincristine (Oncovin) and prednisone
• Radiation therapy
• High-dose chemotherapy and stem cell transplantation
• Targeted therapy: belinostat (Beleodaq), romidepsin   (Istodax)
Hodgkin lymphoma
Classical Hodgkin lymphoma (CHL) •Accounts for about 95% of   all Hodgkin cases in   developed countries, such   as the United States
•Cancer cells are
  Reed-Sternberg cells,   which are much larger   than normal lymphocytes
• ABVD: doxorubicin (Adriamycin), bleomycin (Blenoxane),   vinblastine (Velban) and dacarbazine (DTIC-Dome)
• BEACOPP: bleomycin (Blenoxane), etoposide   (Etopophos), doxorubicin (Adriamycin), cyclophosphamide,   vincristine (Oncovin), procarbazine (Matulane) and   prednisone
• Stanford V: doxorubicin (Adriamycin), mechlorethamine   (Mustargen), vincristine (Oncovin), bleomycin (Blenoxane),   etoposide (Etopophos), prednisone
• ChlVPP: chlorambucil (Leukeran), vinblastine (Velban),   procarbazine (Matulane) and prednisone
• Radiation therapy
• High-dose chemotherapy and stem cell transplantation
• Immunotherapy: nivolumab (Opdivo), pembrolizumab   (Keytruda), rituximab (Rituxan)
• Targeted therapy: brentuximab vedotin (Adcetris)
Nodular sclerosis Hodgkin lymphoma • Highly curable
• Most common in teens   and young adults, but can   occur in people of any age
• Tends to start in lymph   nodes in the neck or chest
• Chemotherapy
• Radiation therapy
• High-dose chemotherapy and stem cell transplantation
• Immunotherapy
Mixed cellularity classical Hodgkin lymphoma • Fast-growing but highly   curable
• Occurs mostly in older   adults but can occur at   any age
• Most often develops in the   upper half of the body
• Chemotherapy
• Radiation therapy
• High-dose chemotherapy and stem cell transplantation
• Immunotherapy
Lymphocyte-rich classical Hodgkin lymphoma • Usually occurs in the   upper half of the body
• Rarely found in more than   a few lymph nodes
• Chemotherapy
• Radiation therapy
• High-dose chemotherapy and stem cell transplantation
• Immunotherapy
Lymphocyte-depleted classical Hodgkin lymphoma • Occurs mostly in older   adults
• More likely to be   advanced when first   found in lymph nodes or   in the abdomen, spleen,   liver and bone marrow
• Chemotherapy
• Radiation therapy
• High-dose chemotherapy and stem cell transplantation
• Immunotherapy
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) • Slow-growing
• Cancer cells are called   popcorn cells because of   how they look
• Cancer cells are variants   of Reed-Sternberg cells
• Chemotherapy
• Radiation therapy
• Immunotherapy

 

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