Treatment for non Hodgkin lymphoma
A team of healthcare professionals decide if you need treatment straight away. They also decide what your treatment options are.
The most common treatment options for non-Hodgkin lymphoma (NHL) are:
chemotherapy
targeted and immunotherapy cancer drugs
steroids
radiotherapy
stem cell transplant
Your treatment depends on what type of NHL you have. On this page we provide a general overview of the treatment for and NHL.
We have more specific information about treatment for some of the different types of NHL. If you know what type you have, you can read more about your treatment by selecting your type from the 'types of NHL' menu page.
Go to the menu page for the different types of NHL
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).
Your MDT usually includes:
a haematologist - a doctor specialising in blood cancers
a specialist haematology nurse - also called a clinical nurse specialist (CNS)
a pathologist - a doctor who diagnoses diseases from examining lymph node biopsies
a clinical oncologist - a doctor specialising in radiotherapy treatment
a pharmacist
a radiologist – a doctor specialising in reading x-rays and scans
Depending on your treatment, your MDT might also include a transplant specialist. You might meet a social worker, psychologist or counsellor.
You might not start treatment straight away if you are well. This depends on your symptoms, and the results of your blood tests and scans.
If you need treatment, your team plans it depending on:
your type of NHL
how fast your NHL is growing - this is the grade
how many places in your body are affected by NHL and where these are – this is the stage
your general health
your age
Your doctor will talk to you about your treatment options. They will discuss the benefits and the possible side effects with you.
Some people only have one type of treatment. Other people need a combination of treatments.
The main types of treatment for NHL are:
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream. Chemotherapy is one of the main treatments for NHL.
There are many chemotherapy drugs. Your treatment depends on what type of NHL you have. You might have a single chemotherapy drug on its own, or a combination of chemotherapy drugs. Or you have chemotherapy together with a targeted drug called rituximab.
Read more about how you have chemotherapy for NHL
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. There are many different types of targeted drugs.
Some targeted drugs are also a type of immunotherapy. These are called monoclonal antibodies (MABs). Rituximab is an example of a MAB. It is a common treatment for NHL. You might have it alongside chemotherapy. This is called chemoimmunotherapy.
Read more about the different targeted cancer drugs for NHL
Steroids are naturally made by our bodies in small amounts. They help to control many body functions. These include the immune system, reducing inflammation and blood pressure.
Prednisolone and dexamethasone are types of steroids. You might have these as part of your NHL treatment.
Radiotherapy uses high energy rays similar to x-rays to destroy cancer cells.
You might have radiotherapy as your main treatment for some NHLs. Or you might have it after chemoimmunotherapy if you have a NHL.
You sometimes have radiotherapy to control symptoms of advanced NHL.
Read more about radiotherapy for NHL
You can have a stem cell transplant after very high doses of chemotherapy. The chemotherapy kills the lymphoma cells and also the stem cells in your bone marrow. After the chemotherapy you have the new stem cells into your bloodstream through a drip.
You might have a stem cell transplant if your NHL comes back and you need more treatment. Or, for some high risk lymphomas you might have a stem cell transplant as part of your first treatment.
Read more about stem cell transplants
There are more than 60 different types of NHL. Your treatment depends on what type you have. We have pages about some of the different types of NHL. If you know what type you have, you can read about your treatment on the page for that NHL type.
Go the menu page for the different types of NHL
Doctors put NHL into groups depending on whether they tend to grow faster or slower. This is called the grade. NHL can be:
low grade - these tend to grow slowly
high grade - these tend to grow more quickly
On this page we provide a general overview of the main treatments for low grade NHL and high grade NHL.
Your treatment depends on which type of NHL you have. Follicular lymphoma is the most common type of low grade NHL. Other types include:
mantle cell lymphoma
marginal zone lymphoma (including MALT lymphoma)
skin (cutaneous) lymphoma
Your doctor might not give you treatment straight away if you don't have any symptoms. Instead, they keep a close eye on you. You might hear this called watch and wait or active monitoring.
Limited disease generally means you have stage 1 or stage 2 NHL. It is also called early stage.
If you need treatment, you are most likely to have radiotherapy to the affected lymph nodes.
Advanced disease generally means you have stage 3 or stage 4 lymphoma. Some people with stage 2 bulky lymphoma might have advanced disease.
Treatment for advanced low grade NHL aims to control it for as long as possible, rather than cure it. Treatment can often control the disease for several years.
There are several phases of treatment for advanced low grade NHL. These are:
Active monitoring You might not start treatment straight away. Your doctor monitors you closely.
First line treatment This is your first treatment. You might have:
a combination of chemotherapy drugs and rituximab – this is called chemoimmunotherapy
rituximab on its own
chemotherapy tablets if you aren’t well enough for combination chemotherapy
Mantle cell lymphoma looks like a low grade lymphoma. But it often grows faster, more like a high grade lymphoma. For mantle cell lymphoma, you might have a stem cell transplant after chemoimmunotherapy. You need to be well enough to have this intensive treatment.
Maintenance treatment You have this for some types of low grade NHL. It aims to delay your lymphoma from coming back. For example, you might have rituximab every 2 months for up to 2 years.
Second line treatment This is the next lot of treatment you have when your lymphoma comes back.
You might have:
a combination of chemotherapy drugs and a drug like rituximab
a drug on its own, such as the chemotherapy drug bendamustine
rituximab on its own
a targeted cancer drug, this might be part of a clinical trial
a stem cell transplant
Your treatment depends on which type of NHL you have. The most common types of high grade NHL are:
diffuse large B cell lymphoma (DLBCL)
Burkitt lymphoma
peripheral T cell lymphoma, such as angioimmunoblastic T cell lymphoma
Limited disease generally means you have stage 1 or stage 2 NHL. It is also called early stage.
You might have:
a short course of chemotherapy with rituximab, followed by radiotherapy
a longer course of chemotherapy with rituximab, without radiotherapy
Advanced disease means you have stage 3 or stage 4 lymphoma. Some people with stage 2 bulky lymphoma might have advanced disease.
The exact choice of treatment depends on which type of high grade NHL you have.
You might have:
chemotherapy with 3 or 4 different drugs – this might be with rituximab (chemoimmunotherapy)
chemotherapy to stop lymphoma spreading to your brain
The chemotherapy combination is quite intensive. You usually have it over 6 to 8 months.
For some types of NHL, you might have a stem cell transplant after chemotherapy, as part of your first treatment. This is usually because your NHL has a very high chance of coming back quickly after standard chemotherapy. You need to be well enough to have this intensive treatment.
Chemotherapy to stop lymphoma spreading to the brain
Some types of NHL are more likely to spread to your brain and spinal cord. To prevent this, you might have a chemotherapy drug called methotrexate. You might have:
injections of methotrexate into the fluid around your spinal cord (intrathecal chemotherapy)
a high dose of methotrexate into your vein (intravenously)
If high grade NHL doesn’t go away or comes back
After treatment, NHL sometimes doesn't go away or it comes back. You might have:
chemotherapy or chemoimmunotherapy, using a different combination of drugs
stem cell transplant
CAR T-cell therapy
targeted cancer drugs
radiotherapy
You might not be fit or well enough to tolerate intense chemotherapy.
Your doctor might suggest a less intensive treatment. For example, you might have:
an adapted combination of drugs that doesn't include certain drugs
lower doses
fewer cycles of treatment
Your doctor will talk to you about the treatment side effects and how these might affect your general health. They will help you decide the best course of treatment for you own situation.
Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.
Find out more about clinical trials and how to take part
Last reviewed: 08 May 2024
Next review due: 08 May 2027
Your treatment depends on the type and stage of your NHL. Common treatments include chemotherapy, targeted and immunotherapy drugs, radiotherapy and a stem cell transplant.
The stage tells you about the number and places in your body that are affected by lymphoma. There are 4 stages for NHL. Or doctors describe it as either early or advanced stage.
There are many different types of non-Hodgkin lymphoma (NHL). Doctors also give NHL a grade, depending on how quickly it is likely to grow.
Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system. There are more than 60 different types of non-Hodgkin lymphoma. They can behave in very different ways and need different treatments.
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