Editing Lymphoma (section)

===High-grade===

Treatment of some other, more aggressive, forms of lymphoma {{which|date=July 2013}} can result in a cure in the majority of cases, but the prognosis for people with a poor response to therapy is worse.<ref name="pmid20008238">{{cite journal | vauthors = Bernstein SH, Burack WR | title = The incidence, natural history, biology, and treatment of transformed lymphomas | journal = Hematology. American Society of Hematology. Education Program | volume = 2009 | pages = 532–541 | year = 2009 | pmid = 20008238 | doi = 10.1182/asheducation-2009.1.532 | s2cid = 12185761 }}</ref> Treatment for these types of lymphoma typically consists of aggressive chemotherapy, including the [[CHOP (chemotherapy)|CHOP or R-CHOP]] regimen. A number of people are cured with first-line chemotherapy. Most relapses occur within the first two years, and the relapse risk drops significantly thereafter.<ref>{{cite journal | vauthors = Jenkins EC | title = Wire-loop application of liquid emulsion to slides for autoradiography in light microscopy | journal = Stain Technology | volume = 47 | issue = 1 | pages = 23–26 | date = January 1972 | pmid = 4550425 | doi = 10.3109/10520297209116530 }}</ref> For people who relapse, high-dose chemotherapy followed by autologous stem cell transplantation is a proven approach.<ref>{{cite journal | vauthors = Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL | display-authors = 6 | title = Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma | journal = The New England Journal of Medicine | volume = 333 | issue = 23 | pages = 1540–1545 | date = December 1995 | pmid = 7477169 | doi = 10.1056/nejm199512073332305 | doi-access = free }}</ref>

The treatment of side effects is also important as they can occur due to the chemotherapy or the [[Hematopoietic stem cell transplantation|stem cell transplantation]]. It was evaluated whether mesenchymal stromal cells can be used for the treatment and prophylaxis of [[graft-versus-host disease]]s. The evidence is very uncertain about the therapeutic effect of mesenchymal stromal cells to treat graft-versus-host diseases on the all-cause mortality and complete disappear of chronic acute graft-versus-host diseases. Mesenchymal stromal cells may result in little to no difference in the all-cause mortality, relapse of malignant disease and incidence of acute and chronic graft-versus-host diseases if they are used for prophylactic reason.<ref>{{cite journal | vauthors = Fisher SA, Cutler A, Doree C, Brunskill SJ, Stanworth SJ, Navarrete C, Girdlestone J | title = Mesenchymal stromal cells as treatment or prophylaxis for acute or chronic graft-versus-host disease in haematopoietic stem cell transplant (HSCT) recipients with a haematological condition | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | pages = CD009768 | date = January 2019 | pmid = 30697701 | pmc = 6353308 | doi = 10.1002/14651858.CD009768.pub2 | editor-last = Cochrane Haematological Malignancies Group }}</ref> Moreover, it was seen that [[platelet transfusion]]s for people undergoing a chemotherapy or a stem cell transplantation for the prevention of bleeding events had different effects on the number of participants with a bleeding event, the number of days on which a bleeding occurred, the mortality secondary to bleeding and the number of platelet transfusions depending on the way they were used (therapeutic, depending on a threshold, different dose schedules or prophylactic).<ref>{{cite journal | vauthors = Estcourt L, Stanworth S, Doree C, Hopewell S, Murphy MF, Tinmouth A, Heddle N | title = Prophylactic platelet transfusion for prevention of bleeding in patients with haematological disorders after chemotherapy and stem cell transplantation | journal = The Cochrane Database of Systematic Reviews | issue = 5 | pages = CD004269 | date = May 2012 | pmid = 22592695 | doi = 10.1002/14651858.CD004269.pub3 | editor-last = Cochrane Haematological Malignancies Group | pmc = 4338578 }}</ref><ref>{{cite journal | vauthors = Estcourt LJ, Stanworth SJ, Doree C, Hopewell S, Trivella M, Murphy MF | title = Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 11 | pages = CD010983 | date = November 2015 | pmid = 26576687 | pmc = 4717525 | doi = 10.1002/14651858.CD010983.pub2 | editor-last = Cochrane Haematological Malignancies Group }}</ref>

Four [[CAR T cell|chimeric antigen receptor T cell]] therapies are FDA-approved for non-Hodgkin lymphoma, including [[lisocabtagene maraleucel]] (for relapsed or refractory large B-cell lymphoma with two failed systemic treatments), [[axicabtagene ciloleucel]], [[tisagenlecleucel]] (for large B-cell lymphoma), and [[brexucabtagene autoleucel]] (for [[mantle cell lymphoma]]). These therapies come with certification and other restrictions.<ref>{{Cite web|last=Ingram|first=Ian|date=2021-02-05|title=New CAR-T for Aggressive B-Cell Lymphoma Wins FDA Nod|url=https://www.medpagetoday.com/hematologyoncology/lymphoma/91089|access-date=2021-02-09|website=www.medpagetoday.com|language=en|archive-date=2021-02-08|archive-url=https://web.archive.org/web/20210208182827/https://www.medpagetoday.com/hematologyoncology/lymphoma/91089|url-status=live}}</ref>

==== Hodgkin lymphoma ====
Hodgkin lymphoma typically is treated with radiotherapy alone, as long as it is localized.<ref name="pmid19883306">{{cite journal | vauthors = Martin NE, Ng AK | title = Good things come in small packages: low-dose radiation as palliation for indolent non-Hodgkin lymphomas | journal = Leukemia & Lymphoma | volume = 50 | issue = 11 | pages = 1765–1772 | date = November 2009 | pmid = 19883306 | doi = 10.3109/10428190903186510 | s2cid = 11004437 }}</ref>

Advanced Hodgkin disease requires systemic chemotherapy, sometimes combined with radiotherapy.<ref name="pmid20008235">{{cite journal | vauthors = Kuruvilla J | title = Standard therapy of advanced Hodgkin lymphoma | journal = Hematology. American Society of Hematology. Education Program | volume = 2009 | pages = 497–506 | year = 2009 | pmid = 20008235 | doi = 10.1182/asheducation-2009.1.497 | doi-access = free }}</ref> Chemotherapy used includes the [[ABVD]] regimen, which is commonly used in the United States. Other regimens used in the management of Hodgkin lymphoma include [[BEACOPP]] and [[Stanford V]]. Considerable controversy exists regarding the use of ABVD or BEACOPP. Briefly, both regimens are effective, but BEACOPP is associated with more toxicity. Encouragingly, a significant number of people who relapse after ABVD can still be salvaged by stem cell transplant.<ref>{{cite journal | vauthors = Viviani S, Zinzani PL, Rambaldi A, Brusamolino E, Levis A, Bonfante V, Vitolo U, Pulsoni A, Liberati AM, Specchia G, Valagussa P, Rossi A, Zaja F, Pogliani EM, Pregno P, Gotti M, Gallamini A, Rota Scalabrini D, Bonadonna G, Gianni AM | display-authors = 6 | title = ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned | journal = The New England Journal of Medicine | volume = 365 | issue = 3 | pages = 203–212 | date = July 2011 | pmid = 21774708 | doi = 10.1056/NEJMoa1100340 | author22 = Gruppo Italiano di Terapie Innovative nei Linfomi | s2cid = 10038896 | doi-access = free }}</ref>

Scientists evaluated whether [[positron emission tomography]] scans between the chemotherapy cycles can be used to make assumptions about the survival. The evidence is very uncertain about the effect of negative (= good prognosis) or positive (= bad prognosis) interim PET scan results on the progression-free survival. Negative interim PET scan results may result in an increase in progression-free survival compared if the adjusted result was measured. Negative interim PET scan results probably result in a large increase in the overall survival compared to those with a positive interim PET scan result.<ref>{{cite journal | vauthors = Aldin A, Umlauff L, Estcourt LJ, Collins G, Moons KG, Engert A, Kobe C, von Tresckow B, Haque M, Foroutan F, Kreuzberger N, Trivella M, Skoetz N | display-authors = 6 | title = Interim PET-results for prognosis in adults with Hodgkin lymphoma: a systematic review and meta-analysis of prognostic factor studies | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 8 | pages = CD012643 | date = January 2020 | pmid = 31930780 | pmc = 6984446 | doi = 10.1002/14651858.CD012643.pub3 | editor-last = Cochrane Haematology Group }}</ref>

Current research evaluated whether [[Nivolumab]] can be used for the treatment of a Hodgkin's lymphoma. The evidence is very uncertain about the effect of Nivolumab for patients with a Hodgkin's lymphoma on the overall survival, the quality of life, the survival without a progression, the response rate (=complete disappear) and grade 3 or 4 serious adverse events.<ref>{{cite journal | vauthors = Goldkuhle M, Dimaki M, Gartlehner G, Monsef I, Dahm P, Glossmann JP, Engert A, von Tresckow B, Skoetz N | display-authors = 6 | title = Nivolumab for adults with Hodgkin's lymphoma (a rapid review using the software RobotReviewer) | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 7 | pages = CD012556 | date = July 2018 | pmid = 30001476 | pmc = 6513229 | doi = 10.1002/14651858.CD012556.pub2 | editor-last = Cochrane Haematological Malignancies Group }}</ref>