Supportive therapy

• Prompt treatment of neutropenic fever/infection
• Broad spectrum antibiotics
• Red cell and platelet transfusion
• Growth factors (GCSF)
• Prophylactic antibiotics and antifungals (e.g. itraconazole or posaconazole) to prevent infection

Improving how we give chemotherapy and radiotherapy

• Increase the doses in those who need it for cure and accept increased side effects
• Reduce chemotherapy or miss out radiotherapy in those who don’t need it to avoid long-term side effects
• Use PET scan in Hodgkin’s lymphoma to help us do this

Targeted therapy

Monoclonal antibodies

• Immune treatment
• Only affects cells which possess target protein
• Avoid side effects
• Most currently used in combination with chemo rather than instead of - so same risks
• More effective than chemotherapy alone

Rituximab

• RCHOP improves responses and cures patients with high grade B cell NHL
  • R-mini-CHOP for elderly patients
• FCR improves survival and prolongs remissions in CLL