My Reports
RGCIRC, Niti Bagh
Lymphoma Treatment in Delhi
A diagnosis of lymphoma can bring uncertainty for patients and their families, especially because lymphoma is not a single disease. It includes several types and subtypes that may grow differently and respond to different treatments. This makes an accurate diagnosis the first and most important step in planning care.
At Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), lymphoma treatment is planned by a multidisciplinary team with expertise in haemato-oncology, medical oncology, radiation oncology, pathology, imaging and stem cell transplantation. The treatment plan is personalised according to the exact lymphoma subtype, stage of the disease, molecular characteristics, symptoms, overall health and previous treatment history.
Depending on individual needs, lymphoma treatment options may include chemotherapy, immunotherapy, targeted therapy, radiation therapy, stem cell transplantation or CAR-T cell therapy. Supportive care is also integrated throughout the treatment journey to help patients manage side effects, maintain strength and navigate treatment with greater confidence.
Understanding Lymphoma and its Main Types
Lymphoma is a type of blood cancer that begins in lymphocytes, the white blood cells that help the body fight infections. These cells are part of the lymphatic system, which includes the lymph nodes, spleen, bone marrow and a network of vessels that carries lymph throughout the body.
Although lymphoma is often discussed as one condition, it includes many diseases that can behave very differently. Some types develop slowly and may remain stable for years, while others progress more quickly and require prompt treatment. This is why identifying the exact type and subtype is essential before treatment begins.
Hodgkin Lymphoma
Hodgkin lymphoma is characterised by the presence of distinctive abnormal cells known as Reed-Sternberg cells. It commonly begins in lymph nodes and may spread in a relatively predictable pattern. Treatment is planned according to the subtype, stage, symptoms and other risk-related features.
Non-Hodgkin Lymphoma
Non-Hodgkin lymphoma is a broad group of cancers that can arise from B cells, T cells or, less commonly, natural killer cells. It includes many subtypes, each with its own pattern of growth and treatment approach.
Non-Hodgkin lymphomas are often described as:
- Indolent lymphomas, which usually grow slowly and may not require immediate treatment in some cases
- Aggressive lymphomas, which develop more rapidly and generally need timely treatment
An accurate diagnosis helps doctors understand how the disease is likely to behave and which treatment options may be most appropriate.
Common Signs and Symptoms of Lymphoma
Lymphoma does not always cause obvious symptoms in its early stages. In many people, the first noticeable sign is a painless swelling in the neck, underarm or groin. These swellings are enlarged lymph nodes and may remain for several weeks without improving.
Other possible lymphoma symptoms include:
- Unexplained fever that keeps returning
- Heavy night sweats that soak clothes or bedding
- Weight loss without trying
- Persistent tiredness that does not improve with rest
- Unexplained itching
- Frequent or recurring infections
- Loss of appetite
- Breathlessness, cough or discomfort in the chest
- Pain, fullness or swelling in the abdomen
The symptoms can differ depending on where the lymphoma develops. For example, lymphoma in the chest may cause coughing or breathing difficulty, while disease affecting the abdomen may lead to bloating, discomfort or a feeling of fullness after eating only a small amount.
It is important to remember that these symptoms do not always mean cancer. Enlarged lymph nodes are commonly caused by infections and often settle on their own. However, a swelling that persists, continues to grow or appears along with fever, night sweats or unexplained weight loss should be assessed by a doctor.
What Causes Lymphoma and Who May Be at Risk?
It is natural to wonder what caused lymphoma, but in most cases, there is no clear answer. Lymphoma develops when certain lymphocytes undergo abnormal changes and begin multiplying without control. Doctors can identify how the disease has developed, but they may not be able to determine what triggered these changes in an individual patient.
Certain factors may, however, increase the likelihood of developing particular types of lymphoma, such as:
- Increasing age, although lymphoma can occur at any age
- A weakened immune system due to a medical condition or immune-suppressing treatment
- Certain autoimmune conditions
- Some infections, including Epstein-Barr virus, HIV and hepatitis C
- Previous chemotherapy or radiation therapy for another cancer
- A close family history of lymphoma in some cases
Risk factors can differ between Hodgkin lymphoma and the many subtypes of non-Hodgkin lymphoma. Having one or more of these factors does not mean that someone will definitely develop the disease. Similarly, many people diagnosed with lymphoma have no known risk factors at all.
Most importantly, a lymphoma diagnosis is not usually the result of something a person did or failed to do. Patients and families should not blame themselves.
How is Lymphoma Diagnosed at RGCIRC?
Being advised to undergo several tests can feel worrying, but each investigation answers a different question. Some tests help confirm whether lymphoma is present, while others identify its exact subtype and show how far it has spread. This detailed evaluation is important because different types of lymphoma may require very different treatments.
Clinical Examination and Blood Tests
The doctor will first discuss the symptoms, how long they have been present and whether there is any relevant medical or family history. They may also examine the neck, underarms, groin, abdomen and other areas for enlarged lymph nodes.
Blood tests may be recommended to check blood-cell counts, liver and kidney function, and markers such as lactate dehydrogenase (LDH). These tests do not confirm lymphoma on their own, but they provide useful information about the patient’s general health and help doctors plan further investigations.
Lymph Node or Tissue Biopsy
A biopsy is usually the most important test for confirming lymphoma. During the procedure, part or all of an enlarged lymph node, or tissue from another affected area, is removed and examined by a pathologist. Whenever practical, a lymph-node biopsy provides the tissue needed to determine the exact lymphoma type. The sample may be studied using histopathology and immunohistochemistry to understand what the abnormal cells look like and which markers they carry.
Flow Cytometry and Molecular Tests
Further tests may include immunophenotyping, flow cytometry, cytogenetic analysis and molecular testing. These investigations help distinguish between lymphoma subtypes and may identify features that influence treatment planning. Next-generation sequencing may also be recommended in selected cases to study genetic changes within the cancer cells. RGCIRC lists flow cytometry, molecular profiling and NGS among its diagnostic capabilities for blood cancers.
Imaging and Other Investigations
PET-CT or CT scans may be used to identify the lymph nodes or organs involved and determine the extent of the disease. PET-CT may also help assess treatment response later in the patient’s care.
A bone marrow aspiration or biopsy may be advised in certain lymphoma types or when the result could affect treatment decisions. However, it is not required for every patient. Once the reports are available, the findings are reviewed together to confirm the diagnosis and determine the lymphoma stage.
Understanding Lymphoma Stages and How Treatment is Planned
Once lymphoma has been diagnosed, the next step is to understand how much of the body is affected. This process is called staging. The stage helps doctors plan treatment, but it is only one part of the overall picture.
Lymphoma is broadly grouped into four stages:
- Stage I: Lymphoma is present in one lymph node region or one nearby area.
- Stage II: Two or more lymph node regions are affected, but they are on the same side of the diaphragm.
- Stage III: Lymph node regions on both sides of the diaphragm are involved.
- Stage IV: Lymphoma has spread to one or more organs outside the lymphatic system, such as the bone marrow, liver or lungs.
Doctors may also use terms such as B symptoms for unexplained fever, heavy night sweats and significant weight loss. Bulky disease means there is a large mass of lymphoma, while extranodal lymphoma refers to disease that has developed outside the lymph nodes.
Hearing that lymphoma is at an advanced stage can be frightening. However, lymphoma staging is different from staging in many solid cancers. Even stage III or IV lymphoma may respond well to treatment, depending on the subtype and other disease-related factors.
How is a Lymphoma Treatment Plan Decided?
Doctors consider several details together before recommending treatment, including:
- Whether it is Hodgkin or non-Hodgkin lymphoma
- The exact subtype and whether it is slow-growing or aggressive
- The stage and areas of the body involved
- Molecular or genetic findings
- Symptoms and disease burden
- Age, overall health and organ function
- Previous treatment, if any
- Whether the lymphoma is newly diagnosed, relapsed or refractory
The aim is to choose a treatment approach that is effective for the specific lymphoma while also considering the patient’s overall health, daily needs and treatment goals.
Lymphoma Treatment Options Available at RGCIRC
Once lymphoma is diagnosed, patients often have the same question: “What treatment will I need?” The answer depends on the exact type of lymphoma, how quickly it is growing, the areas affected and the patient’s overall health. Some people may need treatment immediately, while others can be safely monitored for a period.
At RGCIRC, lymphoma treatment is planned through a multidisciplinary approach. Depending on the diagnosis, the treatment plan may include one or more of the following options.
Active Surveillance or Watchful Waiting
Some indolent, or slow-growing, lymphomas may not cause symptoms or affect organ function for a long time. In such cases, starting treatment immediately may not provide an added benefit. The doctor may instead recommend active surveillance, also known as watchful waiting.
This does not mean that the disease is being ignored. The patient attends regular follow-up appointments and may undergo physical examinations, blood tests and imaging. Treatment is started if the lymphoma begins to grow, causes symptoms or affects the patient’s health. Watchful waiting is an accepted approach for selected people with indolent non-Hodgkin lymphoma.
Chemotherapy and Immunochemotherapy
Chemotherapy uses medicines that travel through the bloodstream to reach lymphoma cells in different parts of the body. It is usually given in cycles, with a treatment period followed by a rest period that allows the body to recover.
For many lymphomas, chemotherapy is combined with a monoclonal antibody that recognises a specific marker on lymphoma cells. This combination is often called immunochemotherapy. The medicines used, number of cycles and gap between treatments depend on the lymphoma subtype, stage and risk profile.
Not every person with lymphoma receives the same chemotherapy. Some may require a shorter course, while others need more intensive treatment or additional therapies. Doctors also monitor blood counts, organ function and side effects throughout the treatment.
Immunotherapy and Monoclonal Antibodies
Immunotherapy helps the immune system recognise or attack lymphoma cells more effectively. Monoclonal antibodies are laboratory-made proteins designed to attach to particular markers on cancer cells. Once attached, they can help the immune system destroy those cells or deliver treatment directly to them.
Depending on the lymphoma subtype, immune-based treatment may be used:
- Along with chemotherapy
- On its own in selected cases
- As maintenance treatment
- When lymphoma returns or does not respond adequately to earlier treatment
Checkpoint inhibitors and other forms of immunotherapy may also be used for selected patients, particularly in some cases of relapsed or refractory Hodgkin lymphoma.
Targeted Therapy
Targeted medicines act on specific proteins, enzymes or pathways that help lymphoma cells grow and survive. Unlike traditional chemotherapy, which affects rapidly dividing cells more broadly, targeted treatment is designed to act on particular features of the cancer.
A targeted medicine may be recommended based on:
- The lymphoma type and subtype
- Biomarker or molecular test results
- Previous treatments
- How the disease responded to earlier therapy
- The patient’s overall condition
Targeted therapy may be given alone or combined with chemotherapy, immunotherapy or other medicines. Different non-Hodgkin lymphoma subtypes may require different targeted approaches, which is why accurate pathological and molecular testing is important.
Radiation Therapy
Radiation therapy uses high-energy beams to destroy lymphoma cells in a carefully selected area. Since it is a local treatment, it is generally used when the disease is limited to a particular part of the body or when one area requires additional treatment.
It may be recommended:
- For certain early-stage lymphomas
- After chemotherapy to treat a remaining or initially bulky area
- To control a localised site of disease
- To relieve pain, pressure or other symptoms
Radiation treatment is planned carefully to target the affected area while limiting exposure to nearby healthy tissues. It may be used alone in selected situations, but it is often combined with systemic treatment.
Stem Cell or Bone Marrow Transplantation
A stem cell transplant may be considered for certain high-risk lymphomas or when the disease returns after initial treatment. It may also be an option when lymphoma does not respond adequately to standard therapy but responds to another course of treatment.
The two main approaches are:
- Autologous stem cell transplant: The patient’s own healthy stem cells are collected, stored and returned after intensive treatment.
- Allogeneic stem cell transplant: Stem cells are received from a suitable donor.
The choice depends on the lymphoma subtype, previous treatment, response to therapy, age, general health and donor availability. Transplantation is not required for every patient and is recommended only after a detailed assessment. RGCIRC provides lymphoma care through a dedicated haemato-oncology and transplant programme.
CAR-T Cell Therapy
CAR-T cell therapy is a personalized form of immunotherapy. The patient’s T-cells, a type of immune cell, are collected and modified in a laboratory so that they can recognise a particular marker on cancer cells. The modified cells are then returned to the patient to find and attack the lymphoma cells.
CAR-T therapy may be considered for selected patients with certain relapsed or refractory B-cell lymphomas, particularly when the disease has not responded to previous treatments or has returned. It requires careful patient selection, specialised preparation and close monitoring before and after the infusion.
Clinical Trials at RGCIRC
RGCIRC has a dedicated clinical research programme that evaluates newer medicines, treatment combinations and therapeutic approaches for different cancers. Patients with lymphoma may be considered for a suitable clinical trial when one is available and matches their lymphoma subtype, treatment history and overall health.
Participation is entirely voluntary. Before enrolment, the treating team explains the purpose of the trial, the treatment involved, possible benefits and risks, and the other available treatment options. Since trial availability changes over time, eligibility can only be confirmed after a detailed evaluation by the lymphoma care team.
How Treatment May Differ Across Lymphoma Types
For Hodgkin lymphoma, treatment usually includes combination systemic therapy, sometimes followed by radiation therapy. Immunotherapy, targeted treatment or stem cell transplantation may be considered when the disease returns or does not respond as expected.
For indolent non-Hodgkin lymphoma, treatment may range from watchful waiting to antibody-based therapy, targeted medicines, chemotherapy or radiation therapy for localised disease.
For aggressive non-Hodgkin lymphoma, treatment generally needs to begin promptly and commonly involves combination systemic therapy. Selected patients with high-risk, relapsed or refractory disease may be evaluated for stem cell transplantation, CAR-T cell therapy or a suitable clinical trial.
A lymphoma is described as relapsed when it returns after responding to treatment. It is called refractory when it does not respond adequately or continues to progress during treatment. In either situation, the doctor may recommend further testing, and sometimes another biopsy, before deciding the next course of treatment.
How Long Does Lymphoma Treatment Take and How is Progress Monitored?
One of the first questions patients and families often ask is, “How long will the treatment continue?” There is no fixed timeline for lymphoma treatment because every lymphoma behaves differently. Some treatment plans may be completed within a few months, while others may continue for longer, especially when maintenance therapy, stem cell transplantation or CAR-T cell therapy is involved.
The duration usually depends on:
- The type and stage of lymphoma
- The treatment recommended
- The number and frequency of treatment cycles
- How well the lymphoma responds
- Whether radiation therapy or another treatment is also required
- Any side effects or infections that require a temporary delay
Before treatment begins, the care team explains the expected schedule and when response assessments are likely to take place.
How is the Response to Treatment Checked?
Doctors monitor progress through physical examinations, blood tests and imaging. Depending on the lymphoma type, a PET-CT or CT scan may be performed during treatment or after it ends to compare the results with earlier scans. PET-CT can help assess how actively the lymphoma is responding, although it is not required in the same way for every subtype.
The response may be described as complete remission, partial remission, stable disease or progressive disease. These findings help doctors decide whether to continue the same treatment, modify it or consider another option.
What is the Success Rate of Lymphoma Treatment?
There is no single success rate that applies to every patient. Outcomes vary considerably according to the lymphoma subtype, stage, molecular features, age, overall health and response to the first treatment.
Many lymphomas can be treated successfully, including some diagnosed at an advanced stage. However, the treating specialist is best placed to explain the likely outcome after reviewing the individual diagnosis and test results.
Supportive Care During and After Lymphoma Treatment
Lymphoma treatment can affect people in different ways. Some may experience tiredness, nausea or appetite changes, while others may need help managing infections, low blood counts or emotional stress. Supportive care is provided alongside cancer treatment to help patients cope better and continue treatment as safely as possible.
At RGCIRC, supportive care may include:
- Regular monitoring and management of treatment-related side effects
- Infection prevention and timely treatment of infections
- Blood or platelet transfusions when required
- Nutritional guidance to support strength and recovery
- Medicines and other measures to manage pain, nausea or fatigue
- Fertility counselling before treatment for eligible patients
- Psychological and emotional support for patients and families
- Physiotherapy and onco-rehabilitation to help rebuild strength and mobility
- Pain, palliative and home-care support when needed
Completing lymphoma treatment does not always mean that medical care ends. Follow-up visits help doctors monitor recovery, check whether the lymphoma remains under control and identify any delayed effects of treatment. The follow-up schedule may include clinical examinations, blood tests and imaging, depending on the lymphoma type and treatment received.
Support may also be needed beyond medical treatment. RGCIRC offers patient- and family-support services, including counselling, nutritional care and accommodation assistance through Ashray for eligible families travelling for treatment. These services are intended to make the treatment journey more manageable for both patients and caregivers.
Why Choose RGCIRC for Lymphoma Treatment in Delhi?
Choosing a hospital for lymphoma treatment can feel overwhelming, especially when patients are still trying to understand their diagnosis. Since lymphoma includes many different subtypes, it is important to receive care at a centre where the diagnosis can be reviewed carefully and specialists from different fields can plan treatment together. Here’s why patients trust RGCIRC for cancer care:
Dedicated Haemato-Oncology and Transplant Expertise
RGCIRC has a dedicated haemato-oncology and stem cell transplant programme for blood cancers, including lymphoma. Care is coordinated by haematologists and medical oncologists, with support from transplant physicians, pathologists, radiologists, radiation oncologists, critical-care specialists and infection-control teams when required. This coordinated approach is particularly important for patients who need intensive treatment, stem cell transplantation or evaluation for cellular therapies.
Multidisciplinary Treatment Planning
Every lymphoma case is different. At RGCIRC, specialists can review the diagnosis, imaging findings, disease stage, molecular reports and the patient’s overall health before recommending a treatment plan. Complex cases may also be discussed by a multidisciplinary tumour board. Patients who have already received a diagnosis elsewhere may seek a second opinion to better understand the available treatment options.
Advanced Tests for an Accurate Diagnosis
Choosing the right treatment begins with identifying the exact lymphoma subtype. RGCIRC’s diagnostic services include histopathology, immunohistochemistry, flow cytometry, molecular testing, cytogenetic evaluation and next-generation sequencing where clinically required. Digital PET-CT and other imaging facilities support staging, treatment planning and response assessment.
Comprehensive Cancer Care Under One Roof
RGCIRC provides access to systemic therapies, precision radiation therapy, stem cell transplantation and CAR-T cell therapy for selected patients within an integrated cancer-care setting. Established in 1996, the Institute is an exclusive cancer centre with a capacity of more than 500 beds and facilities in Rohini and Niti Bagh, South Delhi. It also follows recognised quality standards, including NABH hospital accreditation.
Consult a Lymphoma Specialist at RGCIRC
If you or a loved one has been diagnosed with lymphoma, is waiting for confirmation of the subtype, or needs a second opinion, timely specialist guidance can help bring greater clarity. The haemato-oncology team at RGCIRC can review the diagnosis, explain the available treatment options and recommend the next steps based on the individual condition.
To book a consultation, visit www.rgcirc.org or book online at care.rgcirc.org. You can also download the RGCI Care app on iOS or Android.
For appointments, call +91-11-4702 2222 for Rohini or +91-11-4582 2222 for Niti Bagh, South Delhi.
OPD Hours: Monday to Saturday, 9:00 AM to 5:00 PM
Emergency Services: Available 24×7 at both campuses
Frequently Asked Questions About Lymphoma Treatment
Many lymphomas can be treated successfully, and some can be cured. The outlook depends on the exact subtype, stage, risk factors, overall health and response to treatment. Even advanced-stage lymphoma may respond well, so the stage alone does not determine the outcome.
There is no single treatment that is best for everyone. Treatment may involve chemotherapy, immunotherapy, targeted therapy, radiation therapy, stem cell transplantation or CAR-T cell therapy. The right approach is decided after reviewing the lymphoma subtype, stage, molecular findings and the patient’s overall health.
No. Some slow-growing lymphomas that are not causing symptoms may initially be monitored through active surveillance. Other patients may receive targeted therapy, immunotherapy, radiation therapy or a combination of treatments, depending on their diagnosis.
The duration varies from one patient to another. It depends on the lymphoma type, treatment regimen, number of cycles, response to therapy and whether additional treatment such as radiation or transplantation is required. The care team will explain the expected schedule before treatment begins.
Stage I usually involves one lymph-node area, while Stage II affects two or more areas on the same side of the diaphragm. Stage III involves lymph-node areas on both sides of the diaphragm, and Stage IV means organs outside the lymphatic system are affected. However, treatment planning also considers the lymphoma subtype and other risk-related features.
A stem cell transplant may be considered for certain high-risk, relapsed or refractory lymphomas. The decision depends on how the disease responds to treatment, the patient’s general health and whether an autologous or allogeneic transplant is appropriate. RGCIRC provides both autologous and allogeneic transplantation for selected patients.
CAR-T cell therapy may be an option for selected patients with certain B-cell lymphomas that have returned or have not responded adequately to previous treatments. Eligibility requires detailed evaluation by a specialised cellular-therapy team.
PET-CT is commonly used for staging and response assessment in several lymphoma types, but it may not be required in the same way for every patient. The doctor will decide whether PET-CT, CT or another imaging test is most suitable for the particular subtype.
Choose a centre that offers experienced haemato-oncology care, accurate pathology and molecular testing, PET-CT imaging, multidisciplinary treatment planning and access to advanced options such as stem cell transplantation or CAR-T cell therapy when needed. At RGCIRC, lymphoma care is supported by specialised haemato-oncology, transplant, diagnostic, imaging and supportive-care teams, allowing patients to receive coordinated treatment and follow-up under one roof.