Our 24/7 cancer helpline provides information and answers for people dealing with cancer. We can connect you with trained cancer information specialists who will answer questions about a cancer diagnosis and provide guidance and a compassionate ear.
Our highly trained specialists are available 24/7 via phone and on weekdays can assist through video calls and online chat. We connect patients, caregivers, and family members with essential services and resources at every step of their cancer journey. Ask us how you can get involved and support the fight against cancer. Some of the topics we can assist with include:
For medical questions, we encourage you to review our information with your doctor.
Research into the causes, prevention, and treatment of non-Hodgkin lymphoma (NHL) is being done in many medical centers throughout the world.
Scientists are making a lot of progress in understanding how changes in the DNA inside normal lymphocytes can cause them to develop into lymphoma cells. Once this is understood, drugs may be developed that block these processes.
Progress in understanding DNA changes in lymphoma cells has already led to improved and highly sensitive tests for detecting this disease. Some of these tests are already in use, and others are being developed. They may be used to:
For example, in recent years, genetic tests have shown that there are different subtypes of diffuse large B-cell lymphoma (DLBCL), even though they look the same under the microscope. These subtypes seem to have different outcomes (prognoses) and responses to treatment. The hope is that such tests can be used to help guide treatment decisions.
Much of the research being done on NHL is focused on looking at new and better ways to treat this disease.
Many new chemotherapy drugs are being studied in clinical trials. In recent years, these studies have led to the approval of drugs such as bendamustine (Treanda) and pralatrexate (Folotyn) for use against certain types of lymphoma. Other studies are looking at new ways to combine drugs using different doses or different sequences of drugs.
Researchers continue to improve stem cell transplant methods, including new ways to collect the stem cells before the transplant.
Autologous transplants (which use the patient's own stem cells rather than cells from a donor) have the risk of reintroducing lymphoma cells back into the patient after treatment. Researchers are testing new and improved ways to separate out the last traces of lymphoma cells from the stem cells before they are returned to the patient. Some of the new monoclonal antibodies developed for treating lymphoma may help remove these remaining cells.
Researchers are also studying the effectiveness of non-myeloablative (reduced-intensity) stem cell transplants in people with lymphoma. This approach may allow more people to benefit from stem cell transplants, especially those who are older or in poor health.
As researchers have learned more about lymphoma cells, they have developed newer drugs that target specific parts of these cells. These targeted drugs are different from standard chemotherapy drugs, which work by attacking rapidly growing cells. Targeted drugs may work in some cases where chemotherapy doesn’t, and they often have different side effects.
Some targeted drugs, such as ibrutinib (Imbruvica), acalabrutinib (Calquence), and idelalisib (Zydelig), are already being used to treat some types of NHL, and are being studied for use against other types.
Some other targeted drugs that have shown promise against lymphoma in early studies include:
These and many other targeted drugs are now being studied in clinical trials.
Doctors have known for some time that people’s immune systems may help fight their cancer. Scientists are now trying to develop ways to encourage this immune reaction. Some types of immunotherapy are already being used to treat lymphoma, as discussed in Immunotherapy for Non-Hodgkin Lymphoma.
Monoclonal antibodies: Lymphoma cells have certain proteins on their surface. Monoclonal antibodies can be made to target these proteins and destroy the lymphoma cells while causing little damage to normal body tissues. This treatment strategy has already proven effective. Several such drugs, including rituximab (Rituxan), are already used to treat lymphoma.
Some newer antibodies are attached to substances that can poison cancer cells, and are known as antibody-drug conjugates (ADCs) or immunotoxins. They act as homing devices to deliver the toxins directly to the cancer cells. For example:
Other ADCs are now being studied as well, including polatuzumab vedotin.
Immune checkpoint inhibitors: Immune system cells normally have substances that act as checkpoints to keep them from attacking other healthy cells. Cancer cells sometimes take advantage of these checkpoints to avoid being attacked by the immune system. Some newer drugs, such as pembrolizumab (Keytruda) and nivolumab (Opdivo), work by blocking these checkpoints, which can boost the immune response against cancer cells. These drugs have shown promise in treating several types of cancer, and are now being studied for use against some types of lymphoma.
Chimeric antigen receptor (CAR) T-cell therapy: In this treatment, immune cells called T cells are removed from the patient’s blood and altered in the lab to have specific receptors (called chimeric antigen receptors, or CARs) on their surface. These receptors can attach to proteins on the surface of lymphoma cells. The T cells are then multiplied in the lab and given back into the patient’s blood, where they can seek out the lymphoma cells and launch a precise immune attack against them.
This technique has shown encouraging results in early clinical trials against some hard-to-treat lymphomas. Doctors are still improving how they make the T cells and are learning the best ways to use them. Several CAR T-cell therapies are now FDA approved to treat certain kinds of advanced or recurrent lymphomas, and many others are now being studied in clinical trials.
Lymphoma vaccines: Unlike vaccines against infections like measles or mumps, these vaccines are designed to help treat, not prevent, lymphomas. The goal is to create an immune reaction against lymphoma cells in patients who have very early disease or in patients whose disease is in remission. One possible advantage of these types of treatments is that they seem to have very limited side effects. So far, there have been a few successes with this approach, and it’s a major area of research in lymphoma treatment. At this time, lymphoma vaccines are only available in clinical trials.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Abramson JS. Updated safety and long term clinical outcomes in TRANSCEND NHL 001, pivotal trial of lisocabtagene maraleucel (JCAR017) in R/R aggressive NHL. In: J Clin Oncol 36, 2018; Abstract 7505.
Barta SK. Phase II study of the PD1-inhibitor pembrolizumab for the treatment of relapsed or refractory mature t-cell lymphoma. In: J Clin Oncol 36, 2018; Abstract 7568.
Batlevi CL. Phase I/II clinical trial of ibrutinib and buparlisib in relapsed/refractory diffuse large B-cell lymphoma, mantle cell lymphoma, and follicular lymphoma. In: J Clin Oncol 36, 2018; Abstract 7520.
Dyer Martin JS. Acalabrutinib monotherapy in patients (pts) with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). In: J Clin Oncol 36, 2018; Abstract 7547.
FDA approves axicabtagene ciloleucel for large B-cell lymphoma. (2017, October 17). Retrieved from https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm581296.htm.
Freedman AS, Jacobson CA, Mauch P, Aster JC. Chapter 103: Non-Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Kreitman RJ. Moxetumomab pasudotox in heavily pretreated patients with relapsed/refractory hairy cell leukemia: Results of a pivotal international study. In: J Clin Oncol 36, 2018; Abstract 7004.
Kreitman RJ, Stetler-Stevenson M, Margulies I, et al. Phase II trial of recombinant immunotoxin RFB4(dsFv)-PE38 (BL22) in patients with hairy cell leukemia. J Clin Oncol. 2009;27:2983-2990.
Liu Y. Durable clinical responses observed from non-Hodgkin lymphoma patients treated with autologous CAR-T cells targeting CD19. In: J Clin Oncol 36, 2018; Abstract 3045.
Oki Y. Tenalisib, a dual PI3K δ/γ inhibitor: Safety and efficacy results from an on-going phase I/Ib study in relapsed/refractory T-cell lymphoma. In: J Clin Oncol 36, 2018; Abstract 7510.
Roschewski MJ, Wilson WH. Chapter 106: Non-Hodgkin Lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014.
Sehn LH. Randomized phase 2 trial of polatuzumab vedotin (pola) with bendamustine and rituximab (BR) in relapsed/refractory (r/r) FL and DLBCL. In: In: J Clin Oncol 36, 2018; Abstract 7507.
Wang ML, Rule S, Martin P, et al. Targeting BTK with ibrutinib in relapsed or refractory mantle-cell lymphoma. N Engl J Med. 2013;369:507-516.
Last Revised: July 24, 2020
Donate now so we can continue to provide access to critical cancer information, resources, and support to improve lives of people with cancer and their families.