B Cell Lymphoma Treatment Options

When lymphoma is discovered to affect the B cells, prognosis is generally pretty good almost regardless of subtype. It will almost surely be better than the prognosis for T-cell lymphomas, in large part because B cell lymphomas account for as much as 85% of all Non-Hodgkin's lymphomas, so inevitably more research has gone into these diseases than into the T-cell lymphomas.

Tumor Grades

Perhaps the most important determination is whether the cancer is indolent (slow-growing) or aggressive. This determination is made by the pathologist who reviews slides from the patient's biopsy.

Treatment Options

Watch & Wait

• No treatments are prescribed
• Patient and his/her doctor simply watch and wait for symptoms to appear
• Only used against indolent or slow-growing lymphomas

Radiotherapy

• Used against both indolent and aggressive B cell lymphomas
• Typically used following chemotherapy and against a bulky tumor mass (if the patient has one) in order to make sure all the cancer cells in the patient's body are killed

Chemotherapy

• Most commonly applied B cell lymphoma treatment (including B cell lymphomas that are indolent as well as aggressive)

Although there are several chemotherapeutic drugs used against lymphomas, the most common are cyclophosphamide, doxorubicin, vincristine, prednisone and Rituxan When administered together, this is known as R-CHOP combination chemotherapy, the most commonly used chemotherapy treatment in B cell lymphomas.

Immunotherapy

• Generally refers to one drug: Rituxan, a monoclonal antibody that seeks out only certain cells within the body and kills them
• Used both as a single-agent and in combination chemotherapy
• As a single-agent, Rituxan is often used in what's called maintenance therapy for patients with indolent lymphomas

Radioimmunotherapy (RIT)

This is an emerging treatment option for the indolent subgroup of lymphomas, especially follicular lymphoma.

Two RIT options are currently in use:

• Zevalin
• Bexxar

Although there are differences between these two therapies, both function the same way: They take a monoclonal antibody and attach to it a radioactive isotope, which is injected into the body. The monoclonal antibody seeks out certain lymphocytes and attaches on to them, then delivers the radioactive payload.

These therapies are administered like chemotherapy (through infusions) but kill cancer cells like radiation.

Hematopoietic Stem Cell Transplantation

• Also referred to as bone marrow transplantation
• Generally considered the last line of B cell lymphoma treatment against a particularly refractory B cell lymphoma because the procedure is difficult and potentially fatal

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