Non-Hodgkin's Lymphoma - Chemotherapy

Bendamustine. This potent drug has shown to be effective for indolent NHLs and possibly aggressive lymphomas. One study suggested that a single dose of low-dose etoposide, taken by mouth,may be beneficial for elderly patients.

Side Effects and Complications

Side effects and complications of any chemotherapeutic regimen are common. They are more severe with higher doses. Side effects mayincrease over the course of treatment.

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Common Side Effects. Common side effects include:

Nausea and vomiting --Drugs known as serotonin antagonists, such as ondansetron (Zofran) or granisteron (Kyril), can relieve these side effects in nearly all patients given moderate drugs and most patients who take more powerful drugs. In one study, nearly all patients who took a combination of dexamethasone (a steroid) in combination with ondansetron within 24 hours of chemotherapy experienced either a significant reduction or complete control of nausea and vomiting.
Diarrhea
Hair loss
Weight loss
Depression

These side effects are nearly always temporary. Most patients are able to continue with normal activities for all but perhaps a few days a month.

Serious Side Effects. Serious side effects can also occur and may vary depending on the specific drugs used. They include the following:

Neutropenia is a severe drop in white blood cells. Neutropenia increases the chance for infection from suppression of the immune system.White blood cell count may be improved with the addition of a drug called granulocyte colony-stimulating factor (filgrastim, pegfilgrastim, and lenograstim).There is no evidence that these drugs have any effect on survival or cancer recurrence.
Anemia is a lack of red blood cells. Erythropoetin stimulates red blood cell production and can help reduce or prevent this side effect. It is available as epoetin alfa (Epogen, Procrit) and darbepoetin alfa (Aranesp). Aranesp persists longer in the blood than epoetin alfa and requires fewer injections.
Liver and kidney damage
Abnormal blood clotting (thrombocytopenia)
Allergic reaction

Long-Term Complications.

Fatigue and Somatic Symptoms. Chemotherapy has been associated with long-term somatic symptoms, which are general conditions, such as fatigue and aches and pains that have no apparent physical basis. Fatigue is especially common after chemotherapy and can even last for years.
The most serious long-term complications from chemotherapy are secondary cancers, particularly in people over 40.
Infertility is also a danger, particularly with the use of cyclophosphamide. One study suggested that taking reproductive drugs called GnRH analogs before and during chemotherapy may enhance the function of the ovary and so help preserve fertility in young women.
Some patients report osteoporosis and damage in bone cells, possibly related to corticosteroid treatments.
Regimens containing certain drugs, particularly doxorubicin or mitoxantrone, increase the risk for future heart failure.