What to Know About Immunotherapy for Non-Hodgkin Lymphoma

Immunotherapy is medicine that either boosts your body's immune system or uses man-made versions of normal parts of the immune system to treat the cancer. 

The most common type of immunotherapy now used is monoclonal antibodies. These drugs are like the antibodies your body makes to fight infection. They attach to lymphoma cells, then they kill the cells or block their growth. The most common drug like this used for lymphoma is Rituxan (rituximab), which is often used along with chemotherapy. Others include Campath (alemtuzumab) and Arzerra (ofatumumab). You take these drugs through an intravenous infusion. You'll get them in a doctor's office or clinic.

Other monoclonal antibodies used to treat lymphomas are attached to small radioactive particles. When injected into the body, the antibodies bring the radiation directly to the lymphoma cells to kill them. Drugs in this group include Bexxar (tositumomab) and Zevalin (ibritumomab). 

Still other antibodies are attached to chemotherapy drugs. These antibodies bring the chemotherapy directly to the lymphoma cells. An example of this type of drug is brentuximab vedotin (Adcetris). 

Interferons, which are man-made versions of immune system-boosting proteins, are sometimes used to treat certain lymphomas.

Other drugs, called immunomodulating agents, can also be used to treat some lymphoma, usually after other treatments have been tried. These drugs include Thalomid (thalidomide) and Revlimid (lenalidomide). 

Vaccine therapy is being tested in clinical trials for treatment of non-Hodgkin lymphoma. This type of vaccine uses a substance that prompts the immune system to react to a tumor and kill it.

Potential side effects from immunotherapy for non-Hodgkin lymphoma

The side effects of immunotherapy depend on the type of treatment, as well as other factors.

Monoclonal antibodies

Side effects following this treatment are usually mild. They may include ones such as these:

  • Fatigue or feeling tired

  • Flu-like symptoms, such as fever, chills, and nausea

  • Headache

  • Rashes

  • Swelling

In rare cases, people may have more serious allergic reactions during the IV infusion (especially during the first one), which can lead to low blood pressure and trouble breathing.

Some monoclonal antibodies, especially those that have radioactive molecules or chemotherapy drugs attached to them, are more likely to affect the bone marrow. This can lead to low white blood cell counts, which increases the risk of infection, and low blood platelet counts, which increases the risk of bruising and bleeding.

Interferons

These drugs often cause serious flu-like symptoms, such as fever, chills, headaches, muscle and joint aches, and feeling weak or tired. They can also cause mood changes. These side effects often limit their use against lymphoma.

Immunomodulating agents

Side effects of these drugs can include:

  • Low blood counts

  • Nerve damage, which can cause pain in the hands or feet

  • Blood clots

  • Drowsiness

  • Constipation

  • Birth defects if taken by pregnant women