B cell lymphoma is a subset of the group of diseases called non-Hodgkin lymphoma. According to the Leukemia & Lymphoma Society, these are a diverse group of diseases that involves the lymphatic system of the body. About 85 percent of patients with non-Hodgkin lymphoma have the B cell type; there are fast-growing and slow-growing versions of this lymphoma. Doctors have to take into account the type of lymphoma, the stage and category of the disease and the patient's health when deciding what treatments to use. Available treatments include radiation, chemotherapy and biologic agents.
Radiation Therapy
Radiation therapy uses high-power energy beams to eradicate cancer cells. If a B cell lymphoma is found at an early stage, radiation therapy may be used as the primary treatment, according to the American Cancer Society. Radiation therapy is also used along with chemotherapy to treat more aggressive or advanced lymphomas; radiation can also be used to shrink clusters of lymphoma cells that may be causing problems in different parts of the body. Radiation side effects vary, depending on the location of the therapy and the frequency and intensity of the treatment.
Chemotherapy
Chemotherapy--the use of drugs to kills cancer cells--is often used in combination with radiation therapy in treating B cell lymphoma. Multiple chemotherapy drugs may be used to treat this type of lymphoma and often several of these drugs are used in combination, according to the American Cancer Society. One common combination called CHOP includes cyclophosphamide, doxorubicin, vincristine and prednisone. Another combination omits the doxorubicin from the treatment. If a chemotherapy regimen is not working, doctors can substitute another medication to see if that is more effective. Chemotherapy may be used with biologic therapies as well. Chemotherapy side effects depend on the type and dose.
Immunotherapy
Immunotherapy agents use man-made versions of substances that are part of the human immune system to interfere with lymphoma cells. Agents that are used for B cell lymphomas include rituximab, ibritumomab, alemtuzumab and interferon, as noted by the American Cancer Society. Rituximab, ibritumomab and alemtuzumab are all monoclonal antibodies that were developed to target a specific component on the cancer cell. These agents can be added to a chemotherapy regimen. Ibritumomab and tositumomab can be used for radioimmunotherapy by directing radiation to the lymphoma cells, as noted by the Leukemia & Lymphoma Society. The medication interferon helps the immune system fight infections. According to the American Cancer Society, interferon may make some lymphomas shrink in size.
Growth Factors
Some patients who receive chemotherapy develop low levels of red blood cells, white blood cells and platelets during therapy. Medications called growth factors increase those levels, according to the Leukemia & Lymphoma Society. Agents that can improve red blood cell counts include darbepoetin alfa and epoetin alfa, while the agents G-CSF and GM-CSF can increase the numbers of white cells in the body.
Transplantation
Patients with B cell lymphoma sometimes receive a bone marrow transplant once they achieve remission or after one relapse. The doctors use high-dose chemotherapy to destroy the bone marrow and then replace that marrow with stem cells from a donor. In an allogeneic stem cell transplant, the stem cells come from someone else whose tissue types matches the patient. Another form of stem cell transplant--called an autologous stem cell transplant--uses the patient's own cells to replace the bone marrow. The side effects associated with transplants include increased risk of infection while the new bone marrow is replacing the old bone marrow and side effects associated with the use of chemotherapy agents.
