Non-Hodgkin's Lymphoma - Other Treatments

In general, these drugs cause fewer side effects than traditional chemotherapy. However, serious complications may include skin infections, severe allergic reactions, and temporary lowering of blood counts.

text continues below

Other Monoclonal Antibodies. Other MAbs are being developed that target other antigens on lymphomas. For example, epratuzumab targets CD-22 and is showing promise in early studies. Some are being studied in both conjugated and unconjugated forms and also in combination with MAbs that target different antigens.

Interferon Alpha

Interferon alpha (Intron A) is used as an antiviral drug that also has properties that are effective against some common forms of NHL, particularly low-grade, follicular NHL in advanced stages. It is usually combined with chemotherapy regimens such as CHOP that contain an anthracycline drug (usually doxorubicin). The combination is toxic, however, and outcomes are very variable. Interferon is also being studied for lymphomas in the central nervous system. It may be useful after autologous stem cell transplantation.

Side Effects. Side effects of interferon include flu-like symptoms, severe depression, irritability, weight loss, vomiting, general weakness and loss of strength, and fever. About a third of patients have a severe drop in white blood cells. About 10% of patients cannot tolerate the drug's side effects.

Vaccines

Lymphoma vaccines use the same principles as those that fight other diseases. A protein taken from a lymphoma surface cell is bound to a carrier and administered to the patient. The body's immune system perceives this substance as a foreign antigen and boosts its response not only against the vaccinated substance, but also against the look-alike lymphoma. Clinical trials are ongoing. For example, one vaccine using a protein taken from the tumor called Id-KLH is showing particular promise.

Other Drugs

Cytotoxic Deoxyguanosine Analogue Prodrugs. Nelarabine (Arranon) is approved for treating T-cell lymphoblastic lymphoma (T-LBL). T-LBL is a rare form of lymphoma that accounts for less than 2% of all cases of NHL.

Antisense Oligonucleotide. Oblimersen (G3139) is called an antisense oligonucleotide. It blocks BCL-2, a protein that is genetically overexpressed in some lymphomas and prevents apoptosis (a natural process by which all cells, including cancer cells, self-destruct). To date, studies suggest it may have some activity against mantle-cell lymphoma.

Interleukin 12 (IL-12). IL-12 is a potent immune factor called a cytokine that enhances the body's ability to fight foreign invaders. Experts are investigating whether it will be useful in certain settings--such as in combination with rituximab or after stem cell transplantation.