[Chemotherapy in non-Hodgkin's lymphomas (author's transl)].

The type of therapy in non-Hodgkin's lymphomas (NHL) depends on the state of the disease and on histological classification. As in Hodgkin's lymphoma radiotherapy is indicated with localized disease, whereas chemotherapy is given in disseminated cases. In contrast to Hodgkin's lymphoma chemotherapy is indicated earlier (already in most stage II cases), since dissemination may occur outside the typical lymph node areas. Division of NHLs according to higher or lower degree of malignancy is possible histologically on the basis of the Kiel classification as well as of the Rappaport classification. Low-grade malignant lymphomas are treated best with conventional doses of an alkylating agent. An intensive combined chemotherapy is not indicated. Because of the tendency to early and frequent relapses a cyclic maintenance therapy with an alkylating agent is incidated. High-grade malignant lymphomas have to be treated with agressive combination chemotherapy in order to get the patient into complete remission with the possibility for a long relapse-free interval. Up to now there is no indication that any of the published chemotherapy combinations is definitely superior to the others. It is most important to apply the therapy consequently for at least six months. The value of a maintenance therapy is not yet proven.