“Trust me, I had never heard of it either at the time,” he said. “I had to go through multiple rounds of chemotherapy, radiation, and then I ended up having two bone marrow transplants, which is a pretty stressful situation.”

“Non‑Hodgkin lymphoma is a big category,” Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center, previously told SurvivorNet.

Both Hodgkin and non‑Hodgkin lymphoma are cancers of the lymphatic system, which includes the lymph nodes, spleen, bone marrow, and other immune tissues. Symptoms often overlap—swollen lymph nodes, fatigue, fever, night sweats, and unexplained weight loss—but treatment approaches can differ.

Therapies for non‑Hodgkin lymphoma commonly include chemotherapy, radiation, immunotherapy, and targeted therapy.

Zohn recalled the most frightening moment of his journey: “After my first transplant failed, all of a sudden I was in a situation where I needed a specific drug to get my cancer to simmer down long enough so I could go on to get this second stem cell transplant, which would hopefully save my life.”

Understanding a Stem Cell Transplant Procedure

“The purpose of an autologous transplant is to give your body high‑dose chemotherapy,” explains Dr. Caitlin Costello, a hematologist/oncologist at UC San Diego Health.

The treatment is so intense that without returning stem cells afterward, “your body would never grow bone marrow again.”

In an autologous transplant, the stem cells come from you. Your care team collects them about a week before chemotherapy begins.

WATCH: The Stem Cell Transplant, a Day-by-Day Guide

“Once we have adequate stem cells, we can throw them in the freezer and save them for when we’re ready,” Dr. Costello says. These cells are stored in a medical‑grade freezer with a preservative to keep them safe and fully functional.

Then comes what Dr. Costello calls “the true magic” of the process: a powerful chemotherapy regimen designed to wipe out cancer cells wherever they’re hiding. Many patients receive a four‑drug combination known as BEAM — carmustine, etoposide, cytarabine, and melphalan. This high‑dose therapy acts like “hitting the reset button,” she says, clearing lymphoma cells from the blood and bone marrow.

WATCH: Coping With Stem Cell Transplant Side Effects

The chemotherapy is typically given over five days, either in the hospital or through daily visits. Day six is a planned “day of rest,” when patients usually still feel well because side effects haven’t yet set in. A few days later, symptoms such as nausea, vomiting, diarrhea, or mouth sores may appear, and doctors can offer supportive treatments to ease them.

“Once a patient has received this therapy, their bone marrow will have a dramatic decrease in myeloma cells and healthy cells,” adds Dr. Jing Ye of the University of Michigan Health.

WATCH: What is an Autologous Stem Cell Transplant?

The goal of reinfusing stem cells is to help the body rebuild its blood counts after the chemotherapy has done its job.

Day seven is transplant day. The frozen stem cells arrive packed in dry ice — “it literally looks like frozen bags of blood,” Dr. Costello says. The cells are thawed and infused just like a blood transfusion. After chemotherapy has wiped out your natural stem cells, this infusion “rescues” you, allowing your bone marrow to recover.

From there, your role is mostly to wait.

“The next steps are just letting those stem cells get in there, get comfortable, and start growing,” Dr. Costello says. If all goes well, they’ll repopulate your bone marrow and give your body a fresh start.

Better Understanding Non-Hodgkin Lymphoma

“Non-Hodgkin lymphoma is a big category,” Dr. Vose previously told SurvivorNet.

All non-Hodgkin lymphomas begin in white blood cells known as lymphocytes, which are part of your body’s immune system. From there, doctors separate these cancers into types depending on the specific kind of lymphocytes they grow from, B-cells or T-cells.

WATCH: The type of lymphoma you have matters.

Knowing which of these you have can help steer you to the most appropriate treatment.

One way doctors divide up these cancers is based on how fast they’re likely to grow and spread. “The two main classifications I think of in terms of non-Hodgkin lymphoma are lymphomas that are more indolent and those that are more aggressive because those are treated very differently,” Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, tells SurvivorNet.

Once you’ve been diagnosed with non-Hodgkin lymphoma, the next question your doctor will want to answer is whether you have B-cell or T-cell lymphoma. That answer is important because it will help determine your treatment.

B-cells and T-cells are two kinds of lymphocytes. They’re both infection-fighting cells, but they work in different ways.

About 85% of non-Hodgkin lymphomas affect B cells. These cells produce antibodies, proteins that react to foreign substances like viruses or bacteria in your body. The antibodies attach to another protein on the surface of the invading cells, called an antigen, to target and destroy them.

Types of B-cell lymphoma include:

• Diffuse large B-cell lymphoma
• Follicular lymphoma
• Small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL)
• Mantle cell lymphoma
• Marginal zone lymphomas
• Burkitt lymphoma
• T-cell lymphomas make up only 15% of non-Hodgkin lymphomas. Unlike B-cells,
• T-cells directly destroy bacteria and other invaders.

Types of T-cell lymphoma include:

• T-lymphoblastic lymphoma/leukemia
• Peripheral T-cell lymphomas
• Cutaneous T-cell lymphoma

More On Non-Hodgkin Lymphoma Treatments

Lymphoma treatment largely depends on the nature of your specific diagnosis. For non-Hodgkin lymphoma patients, their cancer is more likely to spread randomly and be discovered in different groups of lymph nodes in the body. Hodgkin lymphoma cancers, on the other hand, are more likely to grow consistently from one group of lymph nodes directly to another.

WATCH: Non-Hodgkin lymphoma treatment options

“There are some lymphomas that are very treatable but not curable,” Dr. Lawrence Piro told SurvivorNet.

Dr. Lawrence Piro is the President and CEO of The Angeles Clinic and Research Institute in Los Angeles, a Cedars-Sinai affiliate. He adds that some lymphomas progress quickly if left untreated.

Non-Hodgkin lymphoma treatment depends on the type, stage, and how fast it grows. People with aggressive non-Hodgkin lymphoma can expect to get a chemotherapy combination called R-CHOP, which is a drug cocktail consisting of chemotherapy drugs plus an antibody drug and a steroid to treat diffuse large B-cell non-Hodgkin lymphoma.

R-CHOP stands for:

• R: Rituximab (Rituxan) is a monoclonal antibody that attaches to a specific protein called CD20, which sits on the surface of B cells. It targets cancerous cells and destroys them.
• C: Cyclophosphamide is a type of chemotherapy drug
• D: Doxorubicin hydrochloride (hydroxydaunomycin) is a type of chemotherapy drug
• V: Vincristine sulfate (Oncovin) is a type of chemotherapy drug
• P: Prednisone is a steroid that lowers inflammation

Patients receiving R-CHOP receive the drug in six cycles that are three weeks apart.

“R-CHOP is a cocktail of drugs. There are five different drugs in that recipe,” Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, tells SurvivorNet.

WATCH: Understanding R-CHOP treatment.

R-CHOP side effects can include:

• Tiredness and weakness
• Hair loss
• Mouth sores
• Bruising and bleeding
• Increased risk of infection
• Appetite loss and weight loss
• Changes in bowel movements

Immunotherapy and targeted therapy are also treatment options for Non-Hodgkin Lymphoma patients.

Rituximab (Rituxan) was the first immunotherapy drug approved to treat some forms of non-Hodgkin lymphoma. “Rituximab is the immunotherapy that has been approved the longest, and we have the most experience with lymphoma,” Dr. Chong tells SurvivorNet.

Rituxan has side effects, including fever, chills, swelling under the skin, itching, and mild shortness of breath.

Brentuximab vedotin (Adcetris) is a relatively new targeted treatment for non-Hodgkin lymphoma and Hodgkin lymphoma. This drug is an antibody-drug conjugate that combines an antibody (a type of protein that recognizes foreign substances in the body) with a drug that treats cancer. It uses a particular protein to deliver medicine directly to the cancer cell.

Non-Hodgkin lymphoma can also be treated with radiation, which aims beams of intense energy at the cancer to stop cancer cells from growing and dividing.

Questions for Your Doctor

If you are dealing with a lymphoma diagnosis, it’s important to ask your doctor a series of questions so you will have an idea of what your next steps will look like. To help you during this difficult time, SurvivorNet has some questions to kickstart your conversation with your physician.

Also, make use of SurvivorNet’s proprietary AI tool “My Health Questions” to further aid your cancer journey.

• What type of lymphoma do I have?
• What does my pathology report say about my diagnosis?
• Should I get a second opinion before I explore possible treatment options?
• Based on my diagnosis, what do you anticipate my treatment path?
• What common side effects should I expect when I begin treatment?
• Will I be able to continue working and performing normal daily activities during treatment?
• Where can I get help working with the insurance company regarding treatment costs?
• Who do you recommend I get mental health help from during my treatment?

Learn more about SurvivorNet's rigorous medical review process.

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