Non-Hodgkin's Lymphoma - Chemotherapy

In general, these serious late side effects are dependent on the cumulative drug dose and rate of administration. There is a 1 - 5% mortality rate from complications of chemotherapy and certain people may be at greater risk. A 2001 study suggested that the risk was highest in those had low performance scores (i.e., are more debilitated than others) or have tests that show low levels of white blood cells.

Supportive Drugs

Granulocyte Colony-Stimulating Factor. Granulocyte colony-stimulating factor or G-CSF (lenograstim, filgrastim, sargramostim, nartograstim) regulates blood-cell growth. It is used to allow higher doses of chemotherapy. Doctors hope it might reduce infections and allow standard chemotherapy treatments and in elderly people, who otherwise could not withstand toxicities. Studies suggest it speeds up recovery after treatment but it is unclear if it reduces the rate of infection. Toxicities and infections are still common, even with the use of G-CSF.

Combinations of Chemotherapy and Radiation (Combined Modality)

Doctors are particularly concerned about the effects of combinations of chemotherapy with radiation, especially leukemia and heart problems. Interestingly, in one study on patients with intermediate- and high-grade NHL, those on chemotherapy alone had more toxic effects than those on combined modality, most likely because it employed fewer cycles of chemotherapy. Better radiation techniques are also reducing the risks of combined modality treatments.

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