Non-Hodgkin's lymphomas are an extensive group of diseases that require a different approach to their treatment. This group includes all lymphomas except lymphogranulomatosis (Hodgkin's lymphoma). These are divided into T-cell and B-cell ones. Some tumors grow rapidly and require immediate treatment, while others take a long time to progress.
Content
- Chemotherapy
- Immunotherapy
- Targeted therapy
- Radiation therapy
- Stem cell transplant
- Treatment in Germany with Booking Health
Chemotherapy
Chemotherapy remains one of the main methods of treatment for the disease. This treatment method involves the prescription of drugs that inhibit tumor growth and eliminate the main symptoms of the disease.
The following groups of drugs can be used:
- alkylating antineoplastic drugs;
- antimetabolites;
- platinum-based drugs;
- purine analogs;
- glucocorticoids.
As a rule, the drugs mentioned above are combined. Up to 4 drugs can be administered at the same time. The choice of a specific drug is determined by the stage and type of lymphoma and a patient's health condition. For example, the very common CHOP drug combination cannot be used in patients with heart disease because one of these drugs has cardiotoxicity.
The courses of chemotherapy are carried out in cycles. Each cycle lasts several weeks. This is followed by a break so that the body can recover after treatment. Chemotherapy is carried out under the control of diagnostic procedures. If it is found that the drugs used no longer work, a chemotherapy regimen will be changed.
In most cases, drugs are injected intravenously or taken by mouth. But most drugs cannot cross the blood-brain barrier. Therefore, if the lymphoma has spread to the structures of the central nervous system, intrathecal chemotherapy may be used. This procedure involves the injection of chemotherapy drugs into the CSF during a lumbar puncture.
Immunotherapy
Immunotherapy helps the patient's immune system to fight the tumor. Patients take some drugs that increase the susceptibility of cancer cells to factors of the immune system or are themselves components of it.
The following drugs can be used for the treatment of non-Hodgkin's lymphomas:
Monoclonal antibodies target certain proteins located on the surface of cancer cells (CD20, CD52, CD30, CD79b). Some antibodies kill cancer cells on their own, while others can be used jointly with chemotherapy drugs and act as signals for the drugs to kill specific cells. Antibodies can sometimes be attached to radioactive molecules for their more precise delivery.
Immune checkpoint inhibitors increase a patient's immune response against cancer cells. The tumor hides from the immune system, trying to impersonate normal tissue. This effect is achieved due to special signal protein molecules. These are called checkpoints. The drugs used block these points, so the immune system begins to attack the tumor.
Immunomodulators stimulate the immune system to fight lymphoma. Their mechanism of action has not been established. These drugs are usually used when other treatment options have been exhausted.
Doctors in Germany offer CAR T-cell therapy. This is a recombinant fusion protein capable of binding to specific antigens. This procedure involves blood collection and isolation of T-cells from it. Under laboratory conditions, chimeric antigen receptors (CARs) appear on their surface after special treatment of these cells. These cells are cultured in the laboratory to increase their numbers. They are then injected back into the patient's blood.
Targeted therapy
Doctors prescribe medications that act primarily on lymphoma cells with only a minimal effect on healthy tissue. That is why such therapy is called targeted. The following medicines can be used:
Proteasome inhibitors block the work of cellular enzymes, which destroy proteins that control cell division. These are used after other treatments for non-Hodgkin's lymphoma have already been tried.
Histone deacetylase inhibitors interact with proteins on chromosomes called histones. These are used to treat T-cell lymphomas.
Kinase inhibitors block kinases, which are cellular proteins that cause the cell to grow and divide. There are two types of kinases that can be targeted by targeted drugs such as phosphoinositide-3-kinase and Bruton's tyrosine kinase.
Radiation therapy
The use of radiation therapy is limited. This can be applied in the following cases:
- stage 1 or 2 of some types of non-Hodgkin's lymphomas (usually mildly aggressive) as the main method of treatment;
- advanced stages of aggressive lymphomas, jointly with chemotherapy;
- the presence of metastatic foci in the structures of the central nervous system, for reducing their size and relieving symptoms.
In addition, people undergoing stem cell transplants also need massive total body irradiation along with high-dose chemotherapy. This is required to destroy tumor cells throughout the body.
Stem cell transplant
An allogeneic stem cell transplant is a more effective treatment method for lymphoma. Allogeneic cells are collected from a donor. This may be a close relative of the patient. If there is no suitable histocompatible person, a donor will be selected from the database. Germany has one of the largest stem cell donor bases on the planet. Therefore, doctors can find material for a transplant procedure for most people if required.
If successful, a stem cell transplant can cure lymphoma completely. But the procedure has its risks. A patient may develop graft-versus-host disease. To prevent this from happening, there must be the best possible compatibility of the patient with the donor. A procedure that uses stem cells from a close relative will be less risky.
Treatment in Germany with Booking Health
If you are seeking to book your non-Hodgkin's lymphoma treatment program in Germany, you are kindly welcome to use the Booking Health service. Our company has been organizing treatment abroad for many years. When using our services, you will get many benefits:
- selection of the best clinic that specializes in oncohematological diseases and achieves the best results in the treatment of all stages of non-Hodgkin's lymphoma;
- reduced cost of treatment due to the lack of overpricing and additional coefficients for foreign patients;
- making your appointment on a preferred date;
- preparation of your treatment program, taking into account your previously performed diagnostic examinations;
- establishment of direct communication with your attending physician;
- control of all the stages of your program;
- control of your invoices and return of unspent funds;
- buying and forwarding medicines;
- organization of additional diagnostic or treatment procedures in Germany;
- communication with the German hospital after the completion of your treatment.
The Booking Health company provides top-class services. We will book airline tickets and a hotel for you, meet you at the German airport and take you to the clinic, provide interpreting services, and provide support throughout the entire period of your stay in Germany.
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:
National Center for Biotechnology
Cancer Research Institute
Cancer Support Community
