Penatalaksanaan

Amirah Muhammad A

Staging of lymphoma
Stage I

Stage II

Stage III

Stage IV

A: absence of B symptoms
B: fever, night sweats, weight loss

HL
LOW
Inter
mediate

HIGH

Pasien stadium IA dan IIA tanpa faktor resiko

radioterapi

Pasien stadium I dan II dengan faktor resiko, dan stadium IIIA

Radioterapi dan Kemoterapi 3-6 siklus dengan toksisitas rendah (klorambusil atau
siklofosfamid atau kombinasi CVP(ciklofosfamid, vincristine, prednison))

Pasien stadium IIIB dan IV

Kombinasi kemoterapi (4 kali siklus kemoterapi sebelum operasi + 2 kali siklus
kemoterapi setelah operasi)
MOPP (mechlorethamine, oncofine, procarbazine, prednison) dan ABVD
(adriamisin, bleomisin, vincristine, dacarbazine)

Commonly Used Classifications

Rappaport
Working Formulation

Diffuse wellSmall lymphocytic

differentiated
lymphocytic
(DWDL or WDLL)
Follicular small cleaved
Nodular poorly
differentiated
lymphocytic (NPDL)
Follicular mixed
Nodular mixed
lymphocytichistiocytic (NM)
Low Grade

Commonly Used Classifications

Rappaport
Working Formulation
Intermediate Grade

Follicular large cell

Diffuse small cleaved
cell
Diffuse mixed
Diffuse large cell

Nodular histiocytic
(NH)
Diffuse poorly
differentiated
lymphocytic
(DPDL)
Diffuse mixed
lymphocytichistiocytic (DM)
Diffuse histiocytic
(DHL)

Commonly Used
Classifications
Working Formulation

Rappaport

High Grade

Large cell immunoblastic

Lymphoblastic lymphoma
Small noncleaved cell
Burkitts
Non-Burkitts

Diffuse histiocytic
(DHL)
Diffuse
lymphoblastic
Diffuse
undifferentiated
(DU)

NHL
LOW

Inter
mediate

HIGH

Kemoterapi : Kemoterapi dengan klorambusil atau

kombinasi dengan COP(ciclofosfamid, oncovin, dan
prednison)
Radioterapi
Stadium I : Kemoterapi (CHOP) + radioterapi
Stadium II-IV
Kemoterapi parenteral kombinasi, radioterapi untuk paliatif
saja

Kombinasi kemoterapi
CHOP (siklofosfamid, hidroxydaunurobicine, vincristine,
prednison)
Re-evaluasi hasil pengobatan: setelah siklus kemoterapi
keempat atau setelah semua siklus lengkap