Lymphoma Chemotherapy Protocols
Protocols for low grade lymphomas are initiated usually with chlorambucil plus allopurinol (for renal protection from the lysis of thousands of cells release of electrolytes) for 5 days per month. This occurs as needed for as many months until the desired response is seen. This is a very gentle chemotherapy regimen, however is known to often cause myelosuppression which is suppression of the growth of your normal blood cells, such as red cells, platelets and white blood cells. Luckily, most patients respond positively to it.
Other chemotherapy protocols for lymphoma include CMF, which denoates cyclophosphamide, mitoxantrone andfludarabine and if needed as shown through flow cytometry or immunohistochemistry, the new biologic rituxamab. MALT if associated with H. pylori. This is treated with H-pak which consists of a PPI, proton pump inhibitor, and 2 antibiotics, one being clarithromycin for a total of 14 days. Disease being regressing thereafter, with very few nonresponders. Endothelial organs can often be involved unfortunately, such as the GI, thyroid, and salivary glands.
High grade lymphomas include Burkitts and Burkitts-like lymphoma. These lymphomas contain the c-myc oncogene. A majority of these cells are also EBV positive. Burkitts like lymphoma may be positive for both c-myc and bcr (an anti-apoptosis protein). Positivity of these markers denotes a much more aggressive disease. High dose c-VAD protocol or McGrath can be subsequently be used.