Treatment for Lymphoblastic Lymphoma

Lymphoblastic lymphoma is almost always treated the same way as physicians treat acute lymphoblastic leukemia. This involves the administration of multiple chemotherapy drugs to bring about remission. Different regimens are used, but all contain Adriamycin (doxorubicin) and prednisone or an intravenous form of a corticosteroid in addition to multiple other drugs.

All patients receive medications to reduce the risk of recurrence in the central nervous system. This is usually done by administering drugs directly into the spinal fluid by either a spinal tap or by placing a “port” directly into the fluid in the brain and leaving the reservoir under the skin of the scalp.

The latter is called an Ommaya reservoir. After remission is obtained, some regimens call for repeating the initial drugs for several cycles, and others call for changing drugs and administering them for 6 to 24 months. Whichever method is used, there is a real chance for a cure. There is some evidence that patients with lymphoblastic lymphoma do best with an autologous bone marrow transplant in first remission. However, all physicians do not agree on this approach, and it has not been uniformly adopted.

When patients with lymphoblastic lymphoma are not cured, second-line therapies have generally been disappointing. Patients who are young enough and for whom a donor is available might have an allogeneic bone marrow transplant, which would give the best chance for a cure.