What can I Expect from Treatment?
The International Prognostic Index (IPI) does give statistically valid estimates of which patients are most likely to relapse, and which patients are less likely to relapse.
Click here to review The International Prognostic Index for Aggressive Lymphoma.
Click here to review The International Prognostic Index for Follicular Lymphoma (FLIPI).
Predicting response to treatment depends on many variables, including the exact type, stage and grade of lymphoma. For example, diffuse large B-cell lymphoma, a type of aggressive (fast-growing) lymphoma, is curable in 80% of patients when the disease is localized to one area of the body. Follicular lymphoma, a type of indolent (slow-growing) lymphoma, is usually spread throughout the body upon diagnosis. Follicular lymphoma can often remain dormant for years or decades requiring little or no treatment. It is responsive to treatment and will often go into remission (cancer-free period) for a period of time following treatment; however, it often relapses.
The variables, other than lymphoma type, stage and grade that can affect the choice and success of treatment, are outlined in the following table:
|Age||Whether a patient is older or younger than 60 years of age.||Younger patients (younger than 60 years old) typically show better responses to treatment. Older patients often cannot tolerate side effects and less aggressive treatments are occasionally chosen.|
|Prior Therapy||Any previous cancer treatment the patient has received.||Patients who have had fewer previous cancer treatments are usually more responsive to new treatments.|
|Performance Status||A term describing how well a patient is able to perform daily tasks and activities.||The better the performance status, the more likely a patient will successfully tolerate and respond to treatment.|
|Blood Proteins||Proteins present in the blood that can be predictors of disease. The important blood proteins in NHL are lactate dehydrogenase (LDH) and beta (2) microglobulin (B2M), both of which indicate aggressive disease if present at high levels.||Patients with normal levels of LDH or B2M tend to respond better to treatment compared with patients who have higher levels.|
|Extranodal Disease||A term describing NHL that has spread outside of the lymphatic system.||Patients whose NHL is contained within the lymphatic system typically show a better response to treatment.|
|Bulky Disease||Any NHL tumour that is greater than 10 cm in diameter.||The presence of bulky disease can indicate a more advanced stage of NHL. Smaller tumours often respond better to therapy than larger ones.|
|Stage of Disease||The extent to which the cancer has spread in the body. NHL is divided into four stages: stages I and II are considered limited (involving a limited area) and stages III and IV are considered advanced (more widespread involvement).||Patients with stage I and II (limited stage) NHL usually have a better chance of a successful response to treatment|
Non-Hodgkin lymphoma (NHL) often responds very well to modern treatments. This does not mean that it is always curable, but it does mean that treatment can often provide long cancer-free periods, reduced symptoms and improved quality of life for many patients. Certain types of NHL often remain dormant for long periods of time and require little or no treatment, while other types of NHL require immediate treatment. Response to treatment depends on the type of NHL and stage/grade of the disease.
There are many different types of treatments for NHL, the most common of which include:
- Watchful Waiting
- Radiation therapy
- Biologic therapies, including:
- Bone marrow or stem-cell transplants
- Experimental treatments obtained through patient participation in clinical trials
Remember, you are a partner in your care and therefore it is important to understand your treatment plan – both for the treatment you will receive now and the treatment you may receive down the road should it become necessary. In some cases, the first treatment may affect the next treatment you will be able to receive. To see an overview of the treatment pathway, click on the following links depending what kind of lymphoma you have: