Treatment of Lymphoma:

Treatment planning takes into account the type of lymphoma, the stage of disease, whether it is likely to grow slowly or rapidly, and the general health and age of the patient. Common treatment options for several types are as follows:

Low Grade

Low-grade lymphomas include small lymphocytic, follicular small cleaved, and follicular mixed cell. For low-grade lymphomas, which usually grow very slowly and cause few symptoms, the doctor may wait until the disease shows signs of spreading before starting treatment.

Although low-grade lymphomas grow slowly and respond readily to chemotherapy, they almost invariably return and are generally regarded as incurable. The long-term outcome has not been favorably affected by the use of intermediate chemotherapy. Single agent or combination chemotherapy or radiation therapy may be required when the disease progresses or begins to cause symptoms.

Intermediate and High Grades

Intermediate grade includes follicular large cell, diffuse small cleaved, diffuse mixed cell, and diffuse large cell. The chance of recovery and choice of treatment depend on the stage of the cancer, age, and overall condition. Whatever the origin, the features that best predict the prognosis and guide decisions about therapy are the size, shape and pattern of the lymphocytes as seen microscopically.

Intermediate-grade and high-grade lymphomas are curable. Treatment for intermediate- or high-grade lymphomas usually involves chemotherapy, with or without radiation therapy. In addition, surgery may be needed to remove a large tumor.

Combination chemotherapy is almost always necessary for successful treatment. Chemotherapy alone, or abbreviated chemotherapy and radiation, cure 70 to 80 percent of patients with limited (Stages I and II) intermediate-grade lymphoma. Advanced (Stages III and IV) disease can be eradicated in about 50 percent of patients.