Immunotherapies use man-made versions of substances normally made by the immune system. These substances may kill lymphoma cells, slow their growth, or activate the patient's own immune system to more effectively fight the lymphoma.

Monoclonal antibodies

Antibodies are proteins made by the body's immune system to help fight infections. Man-made versions, called monoclonal antibodies, can be designed to attack a specific target, such as a substance on the surface of lymphocytes (the cells in which lymphomas start).

Several monoclonal antibodies are now being used to treat lymphoma.

Rituximab (Rituxan): This is an antibody that attaches to a substance called CD20 found on some types of lymphoma cells. This attachment seems to cause the lymphoma cell to die. The treatments are given as intravenous (IV) infusions in the doctor's office or clinic. Common side effects are usually mild but may include chills, fever, nausea, rashes, fatigue, and headaches. Even if these symptoms occur during the first rituximab infusion, it is very unusual for them to recur with later doses. Rituximab may also increase a person's risk of infections.

Ibritumomab (Zevalin) and tositumomab (Bexxar): These newer forms of monoclonal antibodies are similar to rituximab but have radioactive molecules attached to them. The antibodies bring radiation directly to the lymphoma cells, which may help them work better. These drugs are given as intravenous (IV) infusions.

These drugs may prove to be more powerful than rituximab, but they are somewhat harder for doctors to give (because of the radiation dosing involved). They cannot be used with chemotherapy because they also lower blood counts, which may raise the risk of infections, bleeding, or other problems. At this time these drugs are most often used if chemotherapy and/or rituximab are no longer working.

Alemtuzumab (Campath): This antibody is directed at the CD52 antigen. It is useful in some cases of chronic lymphocytic leukemia (CLL) and also some types of peripheral T-cell lymphomas. It is given by injection either under the skin (subcutaneous) or into a vein (IV), usually several times a week. The most common side effects are fever, chills, nausea, and rashes. It can also cause very low white blood cell counts, which increases the risk for infections, so it is often given with antibiotic and antiviral medicines.

Interferon

Interferon is a hormone-like protein made by white blood cells to help the immune system fight infections. Some studies have suggested that giving man-made interferon can cause some types of non-Hodgkin lymphomas to shrink or stop growing.

Common side effects of this treatment include fatigue, fever, chills, headaches, muscle and joint aches, and mood changes. Because of these side effects, interferon is not used very often. It may be given to some patients in addition to chemotherapy.

Last Medical Review: 07/17/2009
Last Revised: 07/17/2009