Treatment for stage 4 lymphoma is typically chemotherapy, which is sometimes followed by radiation, according to Healthline. The specific medication used depends upon the form of the disease. These blood cancers are typically divided into two groups: Hodgkin lymphoma and non-Hodgkin lymphoma.
Patients with stage 4 Hodgkin lymphoma are often given at least six rounds of ABVD chemotherapy, Healthline states. This involves the combination of four drugs: doxorubicin hydrochloride, known by the trade name Adriamycin; bleomycin; vinblastine sulfate; and dacarbazine, explains the National Cancer Institute. Another option is the Stanford V treatment, which uses a mixture of seven drugs. Radiation therapy comes after this chemotherapy.
Another treatment option, the BEACOPP protocol, derives its name from the seven different drugs used during treatment: bleomycin, etoposide, Adriamycin, cyclophosphamide, vincristine, procarbazine and prednisone. Though is effective, this therapy often is more toxic to patients than other treatments, the ASCO Post observes. Sometimes larger does of medication are used if patients do not respond to standard chemotherapy, advises Healthline. In certain cases, a stem cell transplant is performed.
If neither chemotherapy nor transplants prove effective, injections of brentuximab vedotin are given, MedlinePlus says. The drug, which kills cancer cells, is given at three-week intervals. It sometimes causes severe side effects such as blistering and peeling skin, numbness in the extremities, and unusual bleeding.
Treatment for stage 4, slow-growing, non-Hodgkin lymphoma typically begins with rituximab, a type of antibody, discloses Healthline. Chemotherapy is either a single drug, such as bendamustine, or a combination. The more aggressive form of non-Hodgkin lymphoma, which is more common, is treated with a mixture of four drugs, typically cyclophosphamide, doxorubicin, vincristine and prednisone, as well as rituximab.