Non-Hodgkin Lymphoma: Immunotherapy
What is immunotherapy?
Immunotherapy is a treatment that affects the immune system. It can boost your body's immune system. Or it can use synthetic versions of normal parts of the immune system to fight cancer. It’s also called biological therapy. The immune system fights infection by killing germs. And in the same way, it can also destroy cancer cells.
What types of immunotherapy are used to treat non-Hodgkin lymphoma?
The types used to treat non-Hodgkin lymphoma include:
Monoclonal antibody therapy
Monoclonal antibody therapy
Monoclonal antibodies are synthetic versions of immune system proteins. These proteins can be designed to attach to substances on cancer cells. This can help the immune system attack the cancer. These medicines are usually given by an IV or intravenous line that is put in a vein. But some can also be given as an injection under the skin. The treatment is often done at a doctor's office or treatment center.
The most common monoclonal antibody used to treat non-Hodgkin lymphoma is rituximab. This attaches to a substance found on B-cells. It is often given along with chemotherapy, also called chemo. Other medicines that work in a similar way include obinutuzumab and ofatumumab.
Some monoclonal antibodies are attached to small radioactive particles. The antibodies bring the radiation directly to the cancer cells to kill them. An example of this type of medicine is ibritumomab tiuxetan.
Other types of antibodies are attached to chemo medicine. The antibodies bring the chemo right to the cancer cells. An example of this type of medicine is brentuximab vedotin.
Immunomodulating medicines can stimulate your immune system. And they can slow down the growth of cancer cells. They are sometimes used for certain types of non-Hodgkin lymphoma. They are usually used if other treatments are no longer working. Lenalidomide is an example of this kind of medicine. It is taken by mouth. And it is used for treating some types of non-Hodgkin lymphoma.
Possible side effects of monoclonal antibodies
Side effects of these medicines are usually mild. They most often occur during or shortly after the treatment. They may include:
Fatigue or feeling tired
Flu-like symptoms, such as fever, chills, and upset stomach or nausea
Rash or hives
Swelling in the throat or chest tightness
In rare cases, people may have more serious reactions during the treatment. This is a higher risk during the first treatment. This can lead to low blood pressure and trouble breathing.
Some of these medicines can increase the risk of infection in the months after treatment. If you have been infected with the hepatitis B virus in the past, the virus may become active again. Your doctor may test your blood for hepatitis B before you start this medicine.
Monoclonal antibodies that have radioactive molecules or chemo medicines attached to them are more likely to affect the bone marrow. This can lead to low red and white blood cell counts, and low platelet counts. Low red blood cell counts (anemia) can cause fatigue. Low white blood cell counts can increase the risk of infection. Low platelet counts can increase the risk of bleeding and bruising. Some monoclonal antibodies attached to chemotherapy can also affect nerve endings. This can cause tingling, numbness, or pain in the hands and feet.
Possible side effects of immunomodulating medicines
Side effects of these medicines can include:
Low platelet counts, which increase the risk of bleeding
Low white blood cell counts, which increase the risk of infection
Nerve damage, which can cause pain in the hands or feet
Birth defects, if taken by pregnant women
September 24, 2017
NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin's Lymphomas Version 2.2015. National Comprehensive Cancer Network
Alteri, Rick, MD,LoCicero, Richard, MD