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Immunotherapy for Non-Hodgkin Lymphoma

Immunotherapy, also called biological therapy, is a treatment that either boosts your body's immune system or uses man-made versions of normal parts of the immune system to fight non-Hodgkin lymphoma. Just as the immune system fights infection by destroying germ cells that can cause an infection, it can also recognize and destroy cancer cells that cause non-Hodgkin lymphoma.

Immunotherapy is one of many treatment options for non-Hodgkin lymphoma. Other treatment methods include chemotherapy (a drug therapy), radiation therapy (an X-ray treatment), and bone marrow transplants. Although treatments may be used alone, they are often combined. Treatments also are individualized, depending on how far along the cancer is and the particular type of non-Hodgkin lymphoma that's being treated.

How immunotherapy works

Lymphocytes are an important part of the immune system. They normally produce special proteins called antibodies that attach to and mark foreign cells that invade your body. Once an antibody attaches, the rest of your immune system can help destroy the invader. If you've been diagnosed with non-Hodgkin lymphoma (there are about 30 different types), it means that some of your lymphocytes have turned into cancer cells that continue to divide and lose their ability to function normally. Immunotherapy either directs your immune system to help you fight the cancer or uses antibodies to bring other treatments (radiation or chemotherapy) directly to the lymphoma cells.

Various types of immunotherapy are being used to treat non-Hodgkin lymphoma, including monoclonal antibody therapy, interferon therapy, and immunomodulator therapy.

Monoclonal antibody therapy

Antibodies used for this type of immunotherapy are made in a laboratory by injecting mice with cancer cells that make the mice produce antibodies against those cancer cells. Researchers can remove, grow, and use these antibodies to mark cancer cells so that your immune system can attack them. They can also be used to carry radiation or cancer drugs to the cancer cells.

Rituximab (Rituxan) is an example of a monoclonal antibody that is used for a type of non-Hodgkin lymphoma called B-cell lymphoma, often in combination with chemotherapy. It is given by an infusion directly into a vein at a doctor's office or treatment center. It may be given once a week for four to eight weeks. Side effects may include fever, chills, infection, bleeding, headache, and nausea. Some people have also experienced life-threatening or fatal reactions to the drug, so be sure you talk with your doctor about warning signs of dangerous side effects. Women who are pregnant, may become pregnant, or are breastfeeding cannot use this treatment.

Interferon therapy

Interferons are naturally occurring proteins that your body makes in response to infections or cancer. Researchers have been able to produce interferons in the laboratory to use as cancer drugs for some types of non-Hodgkin lymphoma. Interferons may attack cancer cells directly and may also boost your immune system.

A type of interferon called interferon-alpha may be used to treat the non-Hodgkin lymphoma called follicular lymphoma and is also being studied on other lymphomas. Interferon is given by injection under the skin. You may be taught to give yourself injections at home, usually three times a week; treatment may continue for three to six months. Side effects are common and include having flu-like symptoms for several hours after the injection. With this treatment, you'll likely need regular blood tests to monitor your liver enzymes and blood count.

Immunomodulating therapy

Immunomodulating drugs can stimulate your immune system and slow down the growth of cancer cells. They are sometimes used for certain types of non-Hodgkin lymphoma, usually if other treatments are no longer working. Lenalidomide (Revlimid) is an example of an immunomodulating drug that is showing promise in treating non-Hodgkin lymphoma. You might take this drug as a daily pill for three weeks and then once a month over the course of a year. Side effects may include an increased risk for infection and bleeding, as well as nerve damage. It should not be used by pregnant women.

Because immunotherapy is relatively new, many of these treatments are still being studied, and additional types of immunotherapy to treat the many variations of non-Hodgkin lymphoma are under development. If you've been diagnosed with non-Hodgkin lymphoma, learn as much as possible about the disease and work with your medical team to find the available treatment options that best suit you.

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