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Treatment of Non-Hodgkin Lymphoma

Cost for treatment

Non-Hodgkin's Lymphoma Diagnosis
4019.4
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
101356.74
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
11774.23

University Hospital Mannheim

9.8/10
location_onGermany, Mannheim

Department of Hematology and Oncology

According to the reputable Focus magazine, the University Hospital Mannheim ranks among the top medical institutions of Germany, which is an undeniable confirmation of the impeccable medical care and excellent reputation of the hospital! The hospital is a high-tech modern medical institution, which provides accurate diagnosis an
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
222264.72
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
19241.5

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectology

The University Hospital Ulm started its activities 35 years ago and during this time it has become one of the most prestigious medical institutions in Europe. The hospital is famous for its numerous discoveries and the world-class achievements in medicine and pharmaceuticals. The medical facility has 29 specialized departments a
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
283947.37
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
21011.08

University Hospital Freiburg

9.7/10
location_onGermany, Freibung

Department of Hematology and Oncology

The University Hospital Freiburg is famous for its rich history and is one of the oldest and most prestigious medical facilities in Germany (one of the three best medical institutions in the country). The hospital was based on the Faculty of Medicine of the Albert Ludwig University of Freiburg, which celebrated its 550th anniver
Non-Hodgkin's Lymphoma Diagnosis
4614.18
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
304413.95
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
22641.81

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Hematology, Oncology, Adult and Pediatric Rheumatology

According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
Non-Hodgkin's Lymphoma Diagnosis
0
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
0
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
0

University Hospital Frankfurt am Main

10/10

Department of Hematology, Oncology, Hemostaseology, Rheumatology and Infectology

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
263355.52
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
20004.66

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Oncology and Hematology

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
304560.11
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
22402.73

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
242583.05
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
18628.67

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Hematology and Oncology

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
284001.66
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
21383.79

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Hematology and Oncology

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
242482.82
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
19078.64

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Hematology, Oncology and Pulmonology

According to the Focus magazine, the University Hospital Hamburg-Eppendorf ranks among the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena and still occupies it until today. A highly competent medical team of more than 11,000 employees takes care
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
242526.67
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
19242.54

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Charité Comprehensive Cancer Center

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
243028.84
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
19180.95

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Oncology, Hematology, Rheumatology and Immunoncology

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
304491.2
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
22705.49

University Hospital Giessen UKGM

9.5/10
location_onGermany, Giessen

Department of Oncology, Hematology and Palliative Care

The University Hospital Giessen UKGM positions itself as an ultramodern medical facility with outstanding quality of medical care. The hospital presents almost all areas of medicine, ranging from ophthalmology to traumatology and dentistry. The priorities of the hospital’s activities include surgery, neurosurgery, oncology
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
242495.35
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
18994.07

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Oncology, Hematology and Bone Marrow Transplantation

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
304696.87
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
22498.78

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Hematology, Oncology and Immunology

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
242895.2
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
18859.4

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Hematology, Hemostaseology, Oncology and Pulmonology

According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
Non-Hodgkin's Lymphoma Diagnosis
0.00
Allogeneic bone marrow transplantation in Non-Hodgkin lymphoma
242521.45
Chemotherapy (targeted therapy) of Non-Hodgkin lymphoma (B- and T-cell)
19093.25
| from Booking Health GmbH

Non-Hodgkin lymphoma is a large group of tumors originating from T lymphocytes or B lymphocytes. Most neoplasms initially develop in the lymph nodes, which can then spread to soft tissues, internal organs, bone marrow, and the central nervous system. Lymphomas can be indolent (smoldering) and aggressive. These neoplasms develop more often in adults and less often in children.

Oncologists abroad effectively treat any non-Hodgkin lymphomas, and most patients completely get rid of this disease. Drug therapy is usually sufficient to combat this tumor successfully. Sometimes, doctors resort to radiation therapy, CAR T-cell therapy, or a stem cell transplant.

Content

  1. Chemotherapy
  2. Immunotherapy
  3. Targeted therapy
  4. Other types of drug therapy
  5. Radiation therapy
  6. Stem cell transplant
  7. Surgical treatment
  8. Where to undergo lymphoma treatment?

Chemotherapy

 

Chemotherapy is considered the main method for the treatment of non-Hodgkin lymphoma. A treatment regimen depends on the type of the tumor and a patient's age. This may include alkylating agents, corticosteroids, platinum-based drugs, purine analogues, antimetabolites, and other agents. The CHOP or CVP regimen is used for many neoplasms. Chemotherapy is often complemented by targeted therapy and immunotherapy.

The advantage of chemotherapy is that this acts immediately on all tumor foci in the body, so it works well at all stages. Most types of lymphoma are sensitive to cytostatics. A successful therapy leads to a complete cure of the disease.

Sometimes lymphoma spreads to the central nervous system. Most drugs do not penetrate it from the blood due to the blood-brain barrier. In such cases, doctors use intrathecal chemotherapy: drugs are injected into the cerebrospinal fluid through a lumbar puncture.

Immunotherapy

 

Doctors often use immunotherapy in addition to chemotherapy for non-Hodgkin lymphomas. This treatment can be carried out in different versions:

Monoclonal antibodies can target the CD20, CD19, CD52, CD30, and CD79b proteins, depending on the type of the tumor. Chemotherapy agents can sometimes be attached to monoclonal antibodies. As a result, they are delivered directly to the cancer cells. Such drugs are called antibody-drug conjugates. They are usually used as a second-line therapy when "regular" monoclonal antibodies have already been tried.

Immune checkpoint inhibitors are used much less often. These can be applied only for certain types of non-Hodgkin lymphoma, such as primary mediastinal large B-cell lymphoma that has recurred after chemotherapy. The mechanism of action of these drugs is to block molecules that allow the tumor to evade the immune response.

Immunomodulators are usually used for lymphoma in cases where other treatment methods have already been tried and failed. Drugs are prescribed in pills. They stimulate the immune response, allowing a patient's body to fight lymphoma more successfully. Medicines from this group are used with caution in pregnant women because there is a risk of developing congenital malformations in the fetus.

CAR T-cell therapy is an innovative treatment method, the essence of which is that doctors obtain immune cells from the patient's blood, alter them and inject them back into the body. The modified cells attack the tumor. Four drugs have already been approved in Europe and the US for CAR T-cell therapy, which work well for different types of lymphoma: large B-cell, diffuse B-cell, follicular, and mantle cell. Due to the high cost of treatment, the technique is used in the most severe cases when other therapeutic methods cannot cope with the oncological disease.

Targeted therapy

 

Unlike chemotherapy, which affects all cells in the body, targeted therapy targets particular molecular targets detected exclusively in lymphoma cells. Therefore, this drug therapy is more selective about the tumor. At the same time, this requires a personalized approach to prescribing treatment. The therapy is selected based on the molecular diagnosis of cancer and is usually used as a "fallback" treatment option if there is no response to chemotherapy or the tumor recurs after its initial treatment.

Doctors prescribe the following inhibitors to their patients:

  • proteasome;
  • histone deacetylase;
  • Bruton's tyrosine kinase (BTK);
  • phosphoinositide 3-kinases (PI3K);
  • EZH2;
  • nuclear export inhibitors.

Hospitals in developed countries offer the latest drugs, which allow doctors to get good therapeutic results even in patients with advanced oncologic diseases.

Other types of drug therapy

 

For some lymphomas, other drug therapy options can also be used.

For example, MALT lymphoma is caused by Helicobacter pylori infection. Antibiotics are required to suppress it. In the case of gastric lymphomas, patients also receive proton pump inhibitors to reduce the production of hydrochloric acid.

Splenic marginal zone B-cell lymphoma can sometimes be associated with viral hepatitis C. Its destruction by antiviral drugs helps to reduce the tumor size or even cure cancer completely.

Lymphomas often affect not only the lymph nodes, but also the bone marrow. Such patients have a decreased production of blood cells, weak immunity, and blood clotting disorders are possible as well. To prevent complications and to cope with complications that have already developed, doctors use antibiotics, antiviral agents, intravenous immunoglobulin, erythrocyte or platelet mass transfusions.

Radiation therapy

 

Radiation therapy for lymphoma can be used in the following cases:

  • as an independent treatment method for stages 1-2;
  • for aggressive lymphomas, along with chemotherapy;
  • before a stem cell transplant (total body irradiation sometimes supplements high-dose chemotherapy);
  • for relieving symptoms caused by compression of the internal organs, soft tissues, nerves, brain and spinal cord.

Stem cell transplant

 

In the most severe and advanced cases, lymphoma can be treated with a stem cell transplant. This procedure is usually conducted in children or young patients, but is rarely used for older people.

Stem cells provide hematopoiesis. All other blood cells develop from them: erythrocytes, platelets, and immune cells, namely leukocytes. A stem cell transplant can be autologous or allogeneic, depending on whether the cells are transplanted from a patient or from a donor.

When dealing with lymphoma treatment, autologous cells are more commonly used. However, this is only possible if the lymphoma has not spread to the bone marrow. The essence of this procedure is that stem cells are harvested from a patient and frozen, followed by a course of high-dose chemotherapy, sometimes combined with radiation therapy. High doses of drugs completely destroy the lymphoma, but they also irreversibly suppress the bone marrow. The previously harvested stem cells are injected back into the body after a while to restore it.

If the lymphoma has spread to the bone marrow, an autologous transplant is unlikely to eliminate cancer completely. This is because the biomaterial taken from a patient is highly likely to contain cancer cells. In the future, they will grow, and the lymphoma is highly likely to recur after a transplant procedure. Therefore, doctors resort to an allogeneic stem cell transplant in such cases. Donor bone marrow definitely does not contain any cancer cells. In addition, this transplant cannot activate "graft-versus-tumor" responses, which provides an additional therapeutic effect due to immune mechanisms.

Surgical treatment

 

Surgery for lymphoma is rare. If this treatment becomes an option of choice, this is an auxiliary method, but not the main one.

Sometimes surgery can be performed at an early stage of thyroid or gastric lymphoma. However, radiation therapy is the preferred option for dealing with these tumors. Surgery can be considered if radiation therapy is contraindicated (for example, a patient has already received radiation therapy before), or if cancer has to be removed immediately (for example, it compresses the neck and prevents breathing).

Low red blood cell levels become a problem for many patients. To reduce their destruction, doctors may perform a splenectomy, an operation to remove the spleen.

Where to undergo lymphoma treatment?

 

Non-Hodgkin lymphoma can be cured in most cases if you receive medical care in a good clinic abroad. You are welcome to use the Booking Health service to make your treatment appointment in one of the developed countries. There are a few reasons for you to undergo your treatment abroad:

  • you will be treated by reputable doctors in modern and well-equipped Cancer Centers;
  • high-precision diagnostics will determine the type and the subtype of lymphoma to select a personalized treatment;
  • specialists abroad use the latest drugs, including not only chemotherapy, but also targeted therapy, monoclonal antibodies, antibody-drug conjugates, immune checkpoint inhibitors, etc.;
  • availability of complex high-tech procedures, such as a stem cell transplant and CAR T-cell therapy, which help doctors to cure lymphomas even at the advanced stage;
  • doctors use the latest methods of radiation therapy, which treat the tumor while minimally affecting the surrounding tissues.

With the Booking Health service, you can find out the cost of treatment and select a clinic that suits your budget. Our company's specialists will advise you and help you to make the best choice. You will receive insurance that will protect you against unexpected medical expenses. The Booking Health specialists will fully arrange your trip abroad, and you can focus on restoring your health.

 

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

 

Sources:

Cancer Support Community

Cancer. Net

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