Non-Hodgkin Lymphoma Overview

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Treating Non-Hodgkin Lymphoma TOPICS

Immunotherapy for non-Hodgkin lymphoma

Immunotherapy is treatment that uses the patient’s immune system to fight cancer. There are 2 main ways this is done. The patient's own immune system may be made to work better, or the patient can be given man-made versions of the normal parts of the immune system to fight the cancer.

Monoclonal antibodies

These are man-made versions of the antibodies made by the immune system to help fight infections. Instead of attacking germs, they can be designed to attack lymphoma cells. Many monoclonal antibodies are now approved as treatments for lymphoma. Most of them, like rituximab (Rituxan), ofatumumab (Arzerra®), obinutuzumab (Gazyva), and alemtuzumab (Campath®) are plain antibodies. Others are antibodies along with something else attached to them to attack the cancer cells. Ibritumomab (Zevalin®) for example, has a radioactive molecule attached to it. Brentuximab vedotin (Adcetris®) is a monoclonal antibody with a chemotherapy drug attached.

Rituximab is the most commonly used immunotherapy drug in treating non-Hodgkin lymphoma. It is often used along with chemotherapy, but can also be used by itself.

Patients get these treatments as IV infusions in the doctor's office or clinic.

Common side effects are usually mild and might include chills, fever, nausea, rashes, tiredness, and headaches. The antibodies that have radioactive substances attached also tend to lower blood counts. Another important concern is that some of these can cause dormant hepatitis infections to become active again.

More information about how these antibodies are used to treat NHL can be found in our document Non-Hodgkin Lymphoma.


Interferon is a protein made by white blood cells to help fight infections. Some studies suggest that giving man-made interferon can make some types of lymphoma shrink or stop growing. Side effects from this treatment can include tiredness, fever, chills, headaches, muscle and joint aches, and mood changes. Because of these side effects, interferon is not used very often.

Immunomodulating agents

These drugs are thought to work against certain cancers by affecting parts of the immune system, but exactly how they work isn’t clear. They are sometimes used to help treat certain types of lymphoma, often after other treatments have been tried. Both of the immunomodulating agents used for lymphoma, thalidomide (Thalomid®) and lenalidomide (Revlimid®), are more often used to treat a cancer called multiple myeloma.

Common side effects include low blood counts, painful nerve damage, and serious blood clots. Thalidomide can also cause drowsiness, fatigue, and severe constipation.

Because thalidomide causes severe birth defects if taken during pregnancy, it should not be used by women who are or may become pregnant. Access to thalidomide and lenalidomide is tightly controlled to prevent women from taking it when they are pregnant.

Last Medical Review: 08/27/2014
Last Revised: 01/22/2016