Treatment options for lymphoma

A plain-language guide to lymphoma treatments: watch and wait, chemotherapy with immunotherapy, radiation, targeted drugs, stem cell transplant, CAR T-cell therapy and bispecific antibodies.

6 min read · last reviewed September 30, 2026

Lymphoma treatment has changed a lot in recent years. There are more options than ever, and many people respond very well. Your plan will depend on your type of lymphoma, its stage, your symptoms, your age and your overall health. Your team will tailor it to you, and it may change along the way based on how you respond.

Here is an overview of the main approaches, so you know what the words mean.

Watch and wait

For some slow-growing lymphomas, such as follicular lymphoma, the first step may be no treatment at all. This is called watch and wait, or active monitoring. You have regular check-ups, blood tests and sometimes scans.

This can feel strange. You have cancer, and no one is treating it. But studies show that for people without symptoms, starting treatment early doesn't help them live longer. Waiting spares you side effects, sometimes for years. Treatment starts if the lymphoma grows, causes symptoms or affects your organs.

Something you can do: Ask your team which changes you should report between visits, such as new lumps, fevers, night sweats or weight loss.

Chemotherapy and immunotherapy together

Most people who need treatment get chemotherapy, often combined with an antibody treatment. Chemotherapy uses drugs that kill fast-growing cells. It is usually given through an IV in cycles, with rest weeks in between so your body can recover. You usually go home the same day.

Rituximab is an antibody that sticks to a marker called CD20 on many B-cell lymphomas. It flags the lymphoma cells so your immune system can destroy them. It is often added to chemotherapy for B-cell lymphomas.

Your team may use short names made from the first letters of each drug:

• R-CHOP is a common treatment for diffuse large B-cell lymphoma. "R" stands for rituximab. The other letters are chemotherapy drugs and a steroid. For some people, a newer version replaces one drug with an antibody-drug called polatuzumab vedotin.
• ABVD is a common chemotherapy combination for Hodgkin lymphoma. For some people with more advanced Hodgkin lymphoma, one drug is replaced with an antibody-drug called brentuximab vedotin, or an immunotherapy drug is added.
• Bendamustine with rituximab, or other combinations, may be used for slow-growing lymphomas.

After treatment for some slow-growing lymphomas, you may have maintenance: an antibody given every few months for a set time to help keep the lymphoma away.

Common side effects include tiredness, nausea, hair loss with some drugs, mouth sores, numbness or tingling in the hands and feet, and a higher chance of infection. Your team will give you medicines to prevent nausea. You may also get injections that help your body make white blood cells faster, called growth factors.

Radiation therapy

Radiation uses high-energy beams to kill lymphoma cells in one area. It is painless, like having an X-ray, and each session takes a few minutes. It may be used:

• On its own, for some early-stage lymphomas that are only in one area
• After chemotherapy, for early-stage lymphoma or a large (bulky) mass
• To ease symptoms, such as pain from a swollen node

Side effects depend on the area treated. They may include tiredness, skin redness, and a sore throat or upset stomach.

Targeted drugs

Some drugs block the signals lymphoma cells need to grow. For example, BTK inhibitors are pills used for some types, such as mantle cell lymphoma, marginal zone lymphoma and small lymphocytic lymphoma. They are often taken every day for a long time. Your team will tell you if a targeted drug fits your type.

If lymphoma comes back or doesn't respond

This is called relapsed or refractory lymphoma. It is hard news, but there are still good options.

Stem cell transplant. First, you usually get more treatment to shrink the lymphoma. Then some of your own blood-forming stem cells are collected from your blood and stored. Next, you get high-dose chemotherapy to destroy the lymphoma. Your stored stem cells are given back through an IV to help your blood counts recover. This is called an autologous transplant. Less often, stem cells come from a donor.

CAR T-cell therapy. Some of your T cells are collected and changed in a lab so they can find and attack lymphoma cells. They are then given back through an IV. It is done in specialized centres. You will be watched closely for several weeks, and asked to stay near the centre and not drive for a while. Two side effects need quick care:

• Cytokine release syndrome: fever, chills, feeling very unwell, low blood pressure or fast heartbeat.
• Nerve and brain effects: confusion, trouble speaking or writing, shaking, very sleepy or a seizure.

Call your team right away for any fever. Call 9-1-1 for confusion, trouble speaking or a seizure.

Bispecific antibodies. These are newer drugs that hold a lymphoma cell and a T cell together, so the T cell can attack. They can cause similar side effects to CAR T-cell therapy, usually milder, so the first doses may be given in hospital.

Something you can do: Ask whether a clinical trial might be right for you. Trials give access to new treatments and are carefully monitored. They are an option at any stage, not only when other treatments have stopped working.

Looking after yourself during treatment

• Protect your fertility. Some treatments can affect your ability to have children. Ask about storing sperm, eggs or embryos before treatment starts.
• Prevent infection. Wash your hands often, avoid people who are sick, and ask which vaccines you should have.
• Know the fever rule. A temperature of 38 °C (100.4 °F) or higher is an emergency during treatment. Call your cancer centre's 24-hour line right away.
• Get support. Lymphoma Canada and your cancer centre offer support for you and your family.

Questions to ask your care team

• What is the goal of my treatment?
• Which treatment do you recommend for me, and why?
• How long will treatment last, and how often will I come in?
• What side effects should I expect, and which ones should I call about?
• Should I think about fertility preservation before starting?
• Is there a clinical trial that might be right for me?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

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