Induction therapy
If you have advanced-stage non-Hodgkin’s lymphoma (NHL), in which more than two groups of lymph nodes are affected, and you are experiencing symptoms, induction therapy is usually the first step in your treatment plan for indolent NHL.
For follicular lymphoma, it may combine immunotherapy with chemotherapy, as this has been shown to be the most effective way of reducing the number of lymphoma cells in your body.
Bear in mind that everyone’s experience of NHL is different and chemotherapy plus immunotherapy might not be the best treatment for you.
Your doctor or clinical nurse specialist will be able to explain more about your treatment and why it was chosen for you.
How does induction therapy for non-Hodgkin’s lymphoma work?
The aim of the initial induction therapy is to reduce your symptoms and help you enter remission, which will help you live for as long as possible and delay the time until your next treatment
Your initial induction therapy is usually given as a combination of immunotherapy plus chemotherapy. However, immunotherapy or chemotherapy can sometimes be used on their own. Your doctor will decide what kind of induction therapy is best for you based on your type of disease as well as your personal health and circumstances. You will also undergo regular check-ups after induction therapy to monitor your progress.
Non-Hodgkin’s lymphoma (NHL) is a disease of a certain type of white blood cell known as the lymphocyte. By reducing the number of lymphocytes in your body as much as possible, the initial induction therapy can help reduce your symptoms so that you enter remission. This is a period of time when you will feel relatively well and have far fewer symptoms than when your disease is active. This can delay the progression of your disease and help you live longer than you might if you had not started a treatment plan.
Immunotherapy plus chemotherapy helps you enter remission in two ways:
1) Immunotherapy specifically kills the cells that are affected by non-Hodgkin's lymphoma (lymphocytes)
Because lymphocytes (which are a type of white blood cell) are the only type of cells that are affected by lymphoma, killing them can significantly reduce your symptoms. However, healthy lymphocytes are also killed, and this might result in side effects, such as infections.
2) Chemotherapy kills any cells in your body that are growing quickly.
Because lymphoma cells grow more rapidly than normal cells, killing these fast-growing cells with chemotherapy can help remove most of the lymphoma cells from your body. This means your symptoms will be reduced, but you may also get side effects from the chemotherapy affecting normal cells.
Combining these two treatments can therefore be a very effective way of killing as many lymphoma cells as possible, and relieving the symptoms of indolent non-Hodgkin's lymphoma
Tell me more about immunotherapy for non-Hodgkin’s lymphoma
Immunotherapy uses your body’s natural defence system – the immune system – to attack your affected white blood cells (lymphocytes)
Immunotherapy for follicular lymphoma can use either a molecule called a monoclonal antibody or a different molecule called an interferon. Both work by switching on your body's immune system to help fight the lymphoma, but using a monoclonal antibody is more common for follicular lymphoma.
Antibodies occur naturally in our bodies as part of the immune system. They work by recognising invaders, such as bacteria or germs, and helping your body destroy them.
The monoclonal antibodies used for immunotherapy have been specially adapted in the laboratory to recognise and help kill only a certain type of white blood cell: the lymphocytes that can be affected by the non-Hodgkin's lymphoma (NHL).
In this way, immunotherapy for NHL can ‘switch on’ your immune system to help fight the disease.
Immunotherapy with a monoclonal antibody is normally given as a drip, in which the medication is allowed to slowly enter your body through a needle inserted into a vein. A standard course of immunotherapy may take between 3-6 hours.
As this treatment is specific to this one type of white blood cell (the lymphocyte), side effects are usually minor with immunotherapy on its own, and some people don’t experience any.
In other people, however, side effects can be more serious and this should be discussed with your doctor before you begin treatment. You can also find out more from the patient information leaflet that comes with your medication.
Find out more about immunotherapy for non-Hodgkin’s lymphoma
Tell me more about chemotherapy for non-Hodgkin’s lymphoma
There are many different types of chemotherapy, but all of them work in the same way – by killing rapidly growing cells
Each chemotherapy type is designed to work best for a specific type of non-Hodgkin’s lymphoma (NHL). Often, combinations of chemotherapy medicines are used at the same time, so that there is more chance they will kill all the diseased cells. These are named with the initials of the different medicines in the combination.
One course of chemotherapy often takes a few months, with breaks between treatments
You’ll usually get your treatment at an outpatient clinic or in your doctor’s office so that you can go home the same day. Some chemotherapy medicines are given orally, while others have to be injected.
As this treatment kills all fast growing cells, other healthy cells in your body that normally grow quickly are also affected
This explains some of the general side effects of chemotherapy such as sickness and hair loss. The side effects of chemotherapy can vary with different types of drugs and between different people. You should always discuss this in detail with your doctor before you start therapy.