Treating Nodular Lymphocyte-predominant Hodgkin Lymphoma

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare type of Hodgkin lymphoma that tends to grow more slowly than classic Hodgkin lymphoma (cHL). It's often treated differently.

Early-stage NLPHL without B symptoms

If you have early-stage NLPHL without any B symptoms, involved site radiation therapy (ISRT) is often all that's needed.

Another option for some people might be to watch the lymphoma closely at first and then start treatment when symptoms appear.

Early-stage NLPHL, bulky or with B symptoms

If your early-stage NLPHL is bulky (large) or is causing B symptoms, the main treatment is usually chemotherapy followed by radiation therapy (ISRT).

Many doctors use the ABVD chemo regimen, but some prefer other regimens. The monoclonal antibody rituximab (Rituxan^®) might be given alone or with chemotherapy.

See Immunotherapy for Hodgkin Lymphoma for more on rituximab.

Stage III or IV

If your NLPHL is more advanced (stage III or IV), doctors will likely recommend chemotherapy, with or without radiation therapy (ISRT), and/or rituximab. Some patients without B symptoms might be given rituximab alone.

Chemotherapy drugs used for NLPHL

Chemo for NLPHL is not always the same as chemo for classic Hodgkin lymphoma (cHL), although both are treated with a combination of several drugs because different drugs kill cancer cells in different ways.

The combinations used to treat NLPHL are often referred to by abbreviations. Here are the most common combinations used in the US. The monoclonal antibody rituximab (Rituxan^®) can be added to any of them.

CHOP

• Cyclophosphamide (Cytoxan^®)
• Doxorubicin
• Vincristine (Oncovin^®)
• Prednisone

CVbP

• Cyclophosphamide
• Vinblastine
• Prednisolone

See Chemotherapy for Hodgkin Lymphoma to learn more.

ABVD (also used for cHL)

• Adriamycin^® (doxorubicin)
• Bleomycin
• Vinblastine
• Dacarbazine (DTIC)