Non-Hodgkin's lymphoma is a type of cancer that begins in the lymphatic system, which is part of the body’s immune system that fights bacteria. In non-Hodgkin's lymphoma, white blood cells called lymphocytes grow abnormally and can form a growth (tumor) anywhere in the body.

Recent Development

Genetics 

Scientists are learning more and more about the role that genetic changes called heredity and mutations play in the pathogenesis of cancer. As a result, NHL subtypes can be better classified and diagnosed. These genetic profiling techniques can help assess the prognosis of patients with certain types of lymphoma, and these tests are primarily used in lymphoma research. However, in the next few years, it is likely that treatments will target specific genetic changes.

Advances in understanding of DNA changes in lymphoma cells have already led to the development of improved and highly sensitive tests to detect this disease. Some of these tests are already in use and others are in development. It can be used for:

>Finding lymphoma cells in a biopsy sample

>Determination of the type of lymphoma in a person

>It helps to determine the likelihood of a lymphoma growing and spreading even within a specific subtype of lymphoma.

>Find out if a specific treatment can help.

>Helps determine if a lymphoma has been eradicated with treatment or is likely to recur

Chemotherapy

Many new chemotherapy drugs are in clinical trials. In recent years, these studies have approved drugs such as bendamustine (Trenda) and pralatrexate (Polotin) for use in certain types of lymphoma. Other studies are exploring new ways to combine drugs using different dosages or different drug sequences.

Stem cell transplant

Researchers continue to refine stem cell transplantation methods, including new methods of harvesting stem cells prior to transplantation. Autologous transplantation (using the patient's own stem cells instead of donor cells) risks introducing lymphoma cells back into the patient's body after treatment. Researchers are testing a new and improved method of isolating the last traces of lymphoma cells from stem cells before they are returned to patients. Some of the new monoclonal antibodies being developed to treat lymphoma may help get rid of these remaining cells

Targeted therapy

As researchers learn more about lymphoma cells, they have developed new drugs that target specific parts of these cells. These targeted drugs differ from standard chemotherapy drugs, which target fast-growing cells. Targeted drugs may work when chemotherapy is ineffective and often have a variety of side effects. Some targeted drugs, such as ibrutinib (Imbruvica), acalabrutinib (Calquence), and idelalisib (Zydelig), are already being used to treat some types of NHL and are being studied for use in others.

 Some other targeted drugs that have shown promise against lymphoma in early studies include:

 >Phosphatidylinositide 3 kinase (PI3K) inhibitors, such as duvelisib, tenalisib, and buparlisib

>BCL2 inhibitors, such as venetoclax (Venclexta)

>Janus kinase (JAK) inhibitors, such as ruxolitinib

>Tyrosine kinase inhibitors, such as crizotinib, for lymphomas that express the ALK protein.

Immunotherapy

Monoclonal Antibodies: There are specific proteins on the surface of lymphoma cells. Monoclonal antibodies can target these proteins and make them destroy lymphoma cells with little damage to normal body tissues. This treatment strategy has already been proven effective. Some of these drugs, including rituximab (Rituxan), are already being used to treat lymphoma.

 Some new antibodies attach to substances that can poison cancer cells and are known as antibody-drug conjugates (ADCs) or immunotoxins. They act as homing devices, delivering toxins directly to cancer cells.

For instance:

 Brentuximab vedotin (Adcetris) consists of an anti-CD30 antibody that attaches to a cytotoxin. It has been shown to help treat patients with anaplastic large cell lymphoma (ALCL) and is being studied for other types of lymphoma.

Moxetumomab fasodotox targets the CD22 antigen of some lymphoma cells, causing a toxin called PE38. It is used in clinical trials for the treatment of hair cell leukemia (HCL).