Chemotherapy for NHL usually involves several different drugs given at the same time. To treat disease that has spread to the brain, chemotherapy may be delivered to the fluid that surrounds the brain through a needle in the spine. Although used for about 20 years, recent studies suggest this regimen is as effective and has less serious side effects than some of the newer drug combinations, according to Alan Aisenberg, M.D., of Massachusetts General Hospital. An experimental NHL chemotherapy compound is a drug called fludarabine. FDA approved this drug as Fludara in 1991 for treating a type of leukemia, and, according to NCI's Bruce Cheson, M.D., early studies suggest that more low-grade NHL patients go into complete remission when they are treated with fludarabine than when they are treated with standard drugs such as chlorambucil.
Chemotherapy kills off rapidly dividing cells.
Although its prime targets are the rapidly reproducing cancer cells, it also kills healthy dividing cells such as blood cells and the cells lining the intestinal tract and hair follicles. As a result, its side effects can include anemia, an increased risk of infection, mouth sores or bleeding, hair loss, nausea, and vomiting. Some of the chemotherapy drugs used to treat NHL, such as doxorubicin and mitoxantrone, can damage heart tissue, making some people with heart disorders unable to tolerate this treatment. These patients may be given alternative kinds of chemotherapy and radiation therapy. Radiation therapy alone may be the treatment of choice for some patients, especially those who have only a single, small tumor.