Treatment

Proliferation of lymphoblasts may be extremely rapid, with doubling times as short as 24 hours in some histologic types, such as Burkitt lymphoma. Successful therapy of NHL is realized with the recognition that short intervals between drugs (measured in hours) does not allow regrowth of the tumor to its original size. The use of divided-dose cyclophosphamide and other continuous infusions (doxorubicin, cytarabine) with corticosteroids is integral to successful NHL therapy. Treatment groups can be divided into the following categories:

• Localized (stage I and II) lymphoblastic lymphoma (LL)

• Localized (completely resected stage I and abdominal stage II) B-lineage NHL BL, BLL, and diffuse B-cell, large-cell lymphoma (DLCL)

• Intermediate risk (see below)

• BL, BLL, and DLCL with CNS involvement or bone marrow with >25% lym-phoblasts

• Large-cell anaplastic NHL.

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