Newly Diagnosed?
We Can Help Information for those newly diagnosed with lymphoma 
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Each of the many diseases that make up non-Hodgkin's lymphoma has its own natural history. Physicians have developed, or are in the process of developing, specific treatments for each of these types. Current treatment approaches depend on whether a patient's lymphoma is aggressive or indolent, and whether it is at an early or late stage. Below are some of the standard approaches to treatment of various forms of non-Hodgkin's lymphoma.
Indolent Non-Hodgkin's Lymphoma
The following are treatment options for different stages of indolent non-Hodgkin's lymphoma:
Early-Stage Disease (Stage I and Contiguous Stage II)
In early-stage, the lymphoma is localized -- has not spread from its site of origin -- or has spread only to contiguous, or adjacent, lymph node groups. Patients with early-stage disease can be treated with radiation to affected sites or to "extended fields," which cover adjacent nodal sites. Radiotherapy may or may not be combined with chemotherapy.
Advanced-Stage Disease (Non-Contiguous Stage II/III/IV)
The treatment course for patients with indolent, advanced-stage disease depends on whether they have a low or high tumor burden. One option for patients with a small amount of tumor and no symptoms is the so-called "watchful waiting" (or "watch and wait") approach, in which the physician keeps the patient under careful observation and defers therapy. Watchful waiting is not a good option for patients whose tumor burden is high. For these patients, treatment could include chemotherapy-based approaches. Patients with high tumor burden are also potential candidates for treatment with biology-based therapies such as monoclonal antibodies, interferon, or vaccines.
Recurrent Indolent Disease
Standard treatment agents rarely produce a cure in patients whose disease has relapsed. Indolent non-Hodgkin's lymphoma can recur in exactly the same form or in an aggressive form, having undergone a process called "histologic transformation." Bone marrow or peripheral blood stem cell transplantation is an option for these patients. Transplantation is now often preceded by a combination treatment called ICE, a treatment regimen developed at Memorial Sloan-Kettering, that combines three chemotherapeutic agents -- ifosfamide, carboplatin, and etoposide. ICE can significantly improve the tumor response rate and reduce toxicity, and it enables physicians to harvest more stem cells for transplantation. Our doctors have recently found that by adding rituximab to the ICE regimen (RICE), they can further improve the response rate.
Aggressive Non-Hodgkin's Lymphoma
The following are treatment options for different stages of aggressive non-Hodgkin's lymphoma:
Early-Stage & Advanced-State Disease (Stage I, Contiguous Stage II & Non-Contiguous Stage II/III/IV)
Physicians treat patients with early-stage aggressive non-Hodgkin's lymphoma with chemotherapy-based approaches combined with radiation therapy.
Recurrent Aggressive Disease
In patients whose disease has relapsed, high-dose chemotherapy followed by autologous (harvested from the patient) or allogeneic (harvested from a matched donor) bone marrow or peripheral blood stem cell transplantation is more effective than chemotherapy alone. Transplantation is now often preceded by the ICE combination treatment.
