Some people with leukemias and lymphomas never need treatment. Others might not need treatment right away, but may require therapy after several years. Some people might need to be treated right away.

Your patient care team will work with you to determine the treatment that best meets your needs.

Biologic Therapy

Also called immunotherapy, this treatment involves using drugs that boost the immune system’s own ability to fight the cancer. Biologic therapy is an option for treatment of relapsed or refractory hairy cell leukemia and some lymphomas.

Chemotherapy

Chemotherapy is one of the main treatments for lymphomas and many leukemias. Chemotherapy involves administering drugs that kill cancer cells.

Systemic chemotherapy is administered to the whole body via an oral medication or an injection. Chemotherapy may be given as an inpatient or outpatient procedure.

Side effects of chemotherapy

Chemotherapy is effective at killing cancer cells, but it can harm normal cells too, resulting in side effects. Your doctor might adjust your regimen to reduce side effects. Side effects of chemotherapy can include:

• Nausea
• Vomiting
• Hair loss
• Sores inside the mouth
• Diarrhea
• Lack of appetite
• Fatigue
• Increased chance of infection
• Tendency to bruise easily

For pregnant women, chemotherapy can also cause side effects to the fetus, including birth defects. Both mother and fetus must be watched closely during and after chemotherapy.

Targeted Therapy

Targeted therapy involves using drugs that block growth of cancer cells or interfere with processes that help them survive. Examples of targeted therapy include monoclonal antibody therapy, which is used to treat some leukemias and lymphomas.

In this therapy, the antibodies attach to substances that make cancer cells grow, then can kill the cancer cells or keep them from growing. This treatment is administered via an IV infusion.

Other targeted therapy drugs used to treat leukemias include imatinib (Gleevec), rituximab (Rituxan), alemtuzumab (Campath), and ofatumumab (Arzerra).

Steroid Therapy

Steroids (drugs manufactured to mimic the body’s hormones) may be used to kill cancer cells and help make chemotherapy work better. Steroids are often used in combination with several other treatment options.

Radiation Therapy

Radiation (high-energy rays that can kill cancer cells) is one of the main treatments for lymphomas and many leukemias. Radiation can be administered externally using a machine, or internally by implanting seeds, wires, or catheters that emit radiation directly near the cancer.

For pregnant women, radiation should be delayed until after the baby is delivered, if possible, to avoid side effects to the fetus.

Stem Cell Transplant

There are different kinds of stem cell transplants. The two main types are allogeneic and autologous transplant.

In an allogeneic transplant, the patient is given high doses of systemic chemotherapy and sometimes radiation, which destroys the cancer cells and other cells in the bone marrow. The patient is then given stem cells that have been donated by another person, which develop into new, healthy bone marrow cells.

In an autologous transplant, the patient’s own stem cells are removed and stored. Then high doses of systemic chemotherapy or radiation are administered, which destroys the cancer cells and other cells in the bone marrow. Then the patient’s stem cells are returned to the blood, where they will develop into new, healthy bone marrow cells.

This treatment is used in some aggressive forms of leukemia and lymphomas and are being tested in clinical trials for a wider variety of leukemias and lymphomas. Learn more about stem cell transplants at Duke.

Surgery

Surgery may be used for diagnosing lymphomas by obtaining a lymph node biopsy.

Watchful Waiting

Watchful waiting is an option for people with lymphoma and some leukemias, especially people with early stage disease and pregnant women. This approach involves observing the patient without treatment until symptoms appear or change.

Late Effects of Treatment

Patients treated for leukemias or lymphomas may develop side effects from chemotherapy or radiation even months or years after treatment ends. Patients should receive follow-up care from doctors experienced in treatment and management of these effects, which can include:

• Acute myelogenous leukemia
• Disease of the bones, heart, or lungs
• Fatigue
• Infertility
• New cancers, including breast and colorectal cancer

Learn more about leukemias and lymphomas:

• Stages of Leukemias
• Stages of Lymphomas
• Symptoms of Leukemias and Lymphomas