Prognoses and treatments are different for Hodgkin and the different forms of NHL. As a general rule, the faster a lymphoma grows the more sensitive to chemotherapy and curable it can be. Many lymphomas may be curable if detected in early stages.
Many low-grade lymphomas remain indolent for many years and treatment is only initiated if patients become symptomatic. Patients with these types of lymphoma can live near-normal lifespans, but the disease is incurable.
If needed, initial treatment choices include single agent Rituximab, chemo-immunotherapy (e.g. Bendamustine + Rituximab), or clinical trials.
The majority of high grade NHL can be cured with R-CHOP based regimen (R-CHOP, dose adjusted EPOCH-R). In the group of patients who relapse, most relapse within the first two years, and the relapse risk drops significantly thereafter. For those patients high-dose chemotherapy followed by autologous stem cell transplantation is a proven, still potentially curable approach.
Hodgkin lymphoma typically is treated with chemotherapy with a continued declined role of radiotherapy. The most accepted standard chemotherapy regimen is ABVD. Encouragingly, patients who relapse after ABVD can still be potentially cured by an autologous stem cell transplantation.
New treatment strategies in lymphoma
Lymphomas are a very heterogeneous group of malignancies. Individual cases harbor over 1000 genetic alterations/mutations, presenting the challenge of how to separate important “driver“- from inconsequential “passenger”-mutations. Over 100 novel anti-lymphoma targeted agents are in clinical development and some of them will be the building blocks of rational, more effective, and better tolerated treatment algorithms for lymphoid malignancies.
At UCLA, we make the most promising novel agents and combination-regimen available for lymphoma patients. We focus not only on relapsed disease, but have a strong emphasis on novel front-line treatments in an effort to improve lymphoma cure rates and management. Having reached the limits of standard chemo-immunotherapy, and considering all available regimens, clinical trials are offering now the best options for improved outcomes of patients with lymphoid malignancies.
Patients should consider all options available to them, including clinical trials, before making treatment decisions. We conduct trials at UCLA main campus, at our regional satellite sites, as well as in the UCLA-affiliated community-practice network TRIO-US.