Other Treatments for Non-Hodgkin Lymphoma

Bone Marrow Transplant

Non-Hodgkin lymphoma affects bone marrow function. Sometimes levels of healthy blood cells can drop too low. This can happen if the treatment is not working. It can also happen if the lymphoma comes back or is advanced. Chemotherapy can also destroy the healthy cells in the bone marrow. This can make it hard for the body to fight infections and disease. It can lead to life-threatening infections.

A bone marrow transplant (BMT) can restore bone marrow function. BMT uses healthy stem cells (immature, unformed cells) from:

• The person's own bone marrow
• Someone who donates their stem cells

A BMT can be:

Blood Transfusion

A blood transfusion may be used to increase blood cells. It may be used for people who are short of breath, very tired, or who could have serious bleeding. During a transfusion, blood and blood products are infused through an IV. Donated blood will match the person's blood type before the transfusion.

Plasmapheresis

Plasmapheresis is a process to exchange plasma in the blood. Plasma is the liquid part that does not contain cells. Excess proteins thicken plasma making it harder to for blood and other substances to circulate. Circulating blood is removed from the body and spun in a machine. The plasma is cleared of excess proteins and returned to the body. The plasma can be from a donor or a plasma substitute.

Targeted Therapy

Targeted therapy uses medicines to seek out cancer cells and destroy them. They may include:

• Monoclonal antibodies
• Proteasome inhibitors
• Kinase inhibitors

The medicines are given through an IV every few weeks.

Common problems are:

• Feeling tired
• Fever
• Chills
• Nausea or vomiting
• Itching
• Chest pain
• Lightheadedness
• Breathing problems
• Reactivation of hepatitis B infection (for those with an inactive infection)

Treatment During Pregnancy

Treatment of non-Hodgkin lymphoma depends on:

• If the lymphoma is indolent (slow-growing) or aggressive
• How far along the pregnancy is

For indolent lymphomas, watchful waiting may be used until the baby is born. The doctor will closely watch for any changes in the disease during pregnancy.

Some aggressive lymphomas need treatment right away. The doctor may advise ending an earlier stage pregnancy. This is to start life-saving treatment right away. If the pregnancy is later in the term, it may be possible to induce delivery before treatment starts. Keep in mind that treatments vary depending on the type of lymphoma. This option does not apply to everyone who is pregnant.