Non-Hodgkin Lymphoma Treatment in India

Non-Hodgkin lymphoma (NHL) is a type of cancer that originates in the lymphatic system, a component of the body's immune defense network. It occurs when white blood cells called lymphocytes begin to grow abnormally and form tumors in lymph nodes or other lymphoid tissues. Unlike Hodgkin lymphoma, NHL includes a diverse group of subtypes that can behave either slowly (indolent) or aggressively. Common symptoms include fever, unexplained weight loss, swollen lymph nodes, fatigue, and night sweats.

The cost of non-Hodgkin lymphoma treatment in India generally ranges between ₹5,00,000 and ₹25,00,000 ($6,200 – $32,000). This affordability, paired with access to internationally trained oncologists and modern facilities, makes India one of the most sought-after destinations for lymphoma care by international patients.

What Is Non-Hodgkin Lymphoma?

Non-Hodgkin lymphoma (NHL) refers to a group of blood cancers that develop in the lymphatic system, a vital part of the immune system that helps fight infections. Unlike a single disease, NHL encompasses more than 60 distinct subtypes, all originating from the abnormal growth of B cells or T cells: two types of lymphocytes that circulate throughout the body.

In NHL, these lymphocytes lose their ability to function normally and begin multiplying uncontrollably, forming solid tumors in lymph nodes, spleen, bone marrow, or other organs. Some forms of NHL grow very slowly and may not require immediate treatment, while others can progress rapidly and demand urgent medical care.

NHL affects people of all ages, although it's more common in older adults. Its exact cause is often unclear, but risk factors may include weakened immunity, certain infections, autoimmune diseases, or previous exposure to radiation or chemotherapy.

Thanks to medical advances, many forms of non-Hodgkin lymphoma are treatable and even curable, especially when detected early and managed by experienced specialists using a combination of modern therapies.

What are the Types of Non-Hodgkin Lymphoma?

Non-Hodgkin lymphoma is not a single disease but a broad category that includes many different types of lymphatic cancers. The types vary in terms of their growth rates, responses to treatment, and symptoms they cause. Doctors usually classify NHL based on the type of lymphocyte involved—B cells or T cells—and the aggressiveness of the cancer.

B-Cell Lymphomas

Most cases of NHL (around 85%) are B-cell lymphomas. Common subtypes include:

• Diffuse Large B-Cell Lymphoma (DLBCL): This is the most common and aggressive form of lymphoma. It tends to grow quickly but often responds well to chemotherapy.
• Follicular Lymphoma: A slow-growing (indolent) type of NHL that may not require treatment right away. It can be managed effectively over time.
• Mantle Cell Lymphoma: A rare and aggressive subtype that affects older adults and often requires intensive treatment.
• Burkitt Lymphoma: A very fast-growing cancer that is more common in children and young adults. It needs immediate and intensive therapy.

T-Cell Lymphomas

T-cell lymphomas are less common but often more challenging to treat. These include:

• Peripheral T-Cell Lymphoma (PTCL): A group of aggressive cancers that arise in mature T-cells. They typically require a combination of chemotherapy.
• Cutaneous T-Cell Lymphoma (CTCL): A form that mainly affects the skin, such as mycosis fungoides or Sézary syndrome. It grows slowly and may resemble chronic skin conditions.
• Anaplastic Large Cell Lymphoma (ALCL): Can be either aggressive or indolent, affecting both lymph nodes and skin in some cases.

Indolent vs. Aggressive Forms

• Indolent NHL: These slow-growing types can exist for years without significant symptoms. They are often monitored until treatment is necessary.
• Aggressive NHL: These fast-spreading forms require immediate treatment but may have better cure rates if appropriately managed.

What are the Symptoms of Non-Hodgkin Lymphoma?

The symptoms of non-Hodgkin lymphoma (NHL) can vary depending on the type of lymphoma, its growth rate, and the parts of the body affected. Some people may notice early signs, while others might not experience any symptoms until the disease has advanced. 

Some common signs to watch for are:

• Swollen lymph nodes: Painless lumps in the neck, underarm, or groin are often one of the earliest signs. The buildup of abnormal lymphocytes causes these swollen nodes.
• Persistent fatigue: Many people feel exhausted even after rest. It is due to the body fighting cancer or low blood counts caused by bone marrow involvement.
• Unexplained weight loss: Rapid and unintentional weight loss over a short period can be a sign of an aggressive disease.
• Fever and night sweats: Recurring fevers without an infection and drenching night sweats are known as "B symptoms" and may indicate a more advanced or aggressive type of disease.
• Loss of appetite: Many patients report reduced hunger or early satiety, especially when the spleen is enlarged.
• Frequent infections: As the immune system weakens, patients may become more vulnerable to infections, even from common bacteria or viruses.
• Shortness of breath or chest pain: If lymphoma affects lymph nodes in the chest, it can press on the lungs or airways, causing breathing difficulty or discomfort.
• Abdominal pain or swelling: Lymphoma in the abdomen may cause bloating, cramping, or a feeling of fullness due to the enlargement of organs or lymph nodes.

These symptoms can sometimes mimic those of other conditions. A thorough medical evaluation, including imaging, blood tests, and a biopsy, is necessary to confirm the diagnosis.

What are the Treatment Options for Non-Hodgkin Lymphoma?

Treatment for non-Hodgkin lymphoma depends on the type, stage, and aggressiveness of the disease, as well as the patient's age, general health, and personal preferences. Thanks to advancements in oncology, many patients can achieve long-term remission or even complete cure with the right combination of therapies.

The main treatment options used for NHL are:

Chemotherapy

Chemotherapy is the cornerstone of treatment for many types of NHL. It involves the use of anti-cancerous drugs to kill rapidly dividing lymphoma cells. Medical oncologists most commonly use the R-CHOP regimen, which includes:

• Rituximab (a monoclonal antibody)
• Cyclophosphamide
• Doxorubicin
• Vincristine
• Prednisone

Chemotherapy is often given in cycles, with breaks in between to allow the body to recover. It may be used alone or in combination with other treatments, such as radiation or immunotherapy.

Immunotherapy (Monoclonal Antibodies)

Immunotherapy helps the immune system recognize and attack cancer cells. One of the most essential drugs in this category is Rituximab, which targets CD20, a protein found on the surface of B-cell lymphoma cells.

Other newer immunotherapy drugs may be used in relapsed or refractory cases, especially in patients who do not respond to standard chemotherapy.

Targeted Therapy

Targeted therapies work by interfering with specific genes or proteins that help lymphoma cells grow. Examples include:

• Ibrutinib – used in mantle cell lymphoma and certain slow-growing types
• Venetoclax – used in combination for advanced or resistant NHL
• Lenalidomide – useful in some follicular and transformed lymphomas

These drugs are often taken orally and tend to have fewer side effects than chemotherapy.

Radiation Therapy

Radiation therapy utilizes high-energy beams to target and destroy lymphoma cells. It is typically used:

• As a consolidation therapy after chemotherapy
• For localized lymphomas in early stages
• To relieve symptoms in bulky or painful lymph nodes

Radiation is often combined with chemotherapy, especially in early-stage disease.

Stem Cell Transplant (Bone Marrow Transplant)

A bone marrow transplant may be recommended for patients with relapsed or high-risk NHL. The process involves:

• High-dose chemotherapy to wipe out cancer cells
• Infusion of healthy stem cells to restore bone marrow function

There are two types:

• Autologous bone marrow transplant (patient's own stem cells)
• Allogeneic bone marrow transplant (donor stem cells)

India offers both options at significantly lower costs compared to Western countries, with excellent outcomes in top-tier hospitals.

Watchful Waiting

For slow-growing, indolent lymphomas that are not causing symptoms, doctors may recommend "active surveillance" or watchful waiting. In such cases, treatment is delayed until there's evidence of progression. This approach avoids unnecessary side effects and enables patients to maintain their quality of life until therapy becomes necessary.

Non-Hodgkin Lymphoma Treatment Cost in India

India is a global hub for affordable, high-quality cancer care, and the treatment of non-Hodgkin lymphoma is no exception. The total cost of managing NHL in India depends on several factors, such as the subtype of lymphoma, stage of disease, choice of medications, hospital infrastructure, and whether a bone marrow transplant is involved.

The cost of non-Hodgkin lymphoma treatment in India ranges between ₹5,00,000 and ₹25,00,000 ($6,200 – $32,000). The cost estimate includes hospital stays, chemotherapy cycles, targeted or immunotherapy, consultations, diagnostic tests, and medications.

Here's a closer look at what this cost range includes:

Treatment Component	Estimated Cost (INR)	Estimated Cost (USD)
Initial Consultation and Investigations	₹40,000 – ₹70,000	$480 – $850
Biopsy and Immunophenotyping	₹25,000 – ₹45,000	$300 – $540
Chemotherapy (R-CHOP, 6–8 cycles)	₹2,50,000 – ₹4,50,000	$3,000 – $5,400
BR Regimen for indolent lymphomas (6–8 cycles)	₹3,00,000 – ₹5,50,000	$3,600 – $6,600
Rituximab (each dose)	₹60,000 – ₹1,00,000	$720 – $1,200
Targeted Therapy (Ibrutinib, etc.) per month	₹1,00,000 – ₹2,50,000	$1,200 – $3,000
Stem Cell Transplant (Autologous)	₹15,00,000 – ₹20,00,000	$18,000 – $30,000
Radiation Therapy (if required)	₹1,00,000 – ₹1,50,000	$1,200 – $1,800
Supportive Medications & Injections	₹50,000 – ₹1,00,000	$600 – $1,200

Inclusions in the Cost of Non-Hodgkin Lymphoma Treatment

What makes India especially attractive is that these costs typically cover:

• Oncologist and hematologist consultation
• Daycare or inpatient chemotherapy
• Nursing care and hospital charges
• Routine imaging (X-ray, CT, PET-CT in select packages)
• Lab monitoring (CBC, liver/renal function tests)
• Anti-nausea, antifungal, and antibiotic prophylaxis
• Post-treatment follow-up during hospital stay

In some hospitals, fixed-cost packages are offered for specific chemotherapy regimens, giving patients financial predictability. Additionally, patients who respond well to therapy often avoid the cost of stem cell transplantation, which significantly reduces the overall expense.

Cost Comparison: Non-Hodgkin Lymphoma Treatment in India vs Other Countries

One of the most compelling reasons overseas patients travel to India for non-Hodgkin lymphoma treatment is the massive cost difference compared to many Western and developed nations. While offering care that matches global standards, India remains far more affordable without compromising on quality, safety, or clinical outcomes.

Below is a comparison of average treatment costs across different countries for a full course of NHL therapy (including diagnosis, chemo, supportive care, and follow-ups):

Country	Average Treatment Cost (USD)	Remarks
India	$6,200 – $32,000	Full treatment including chemo, diagnostics, medications
United States	$60,000 – $120,000	Insurance-dependent; often excludes transplant or ICU stay
United Kingdom	$50,000 – $90,000 (private care)	Covered under NHS but with long wait times for non-urgent NHL
United Arab Emirates	$45,000 – $75,000	Private hospitals only; higher medication costs
Singapore	$40,000 – $80,000	Comparable care, but significantly more expensive
Turkey	$15,000 – $30,000	Competitive rates; limited use of advanced biologics
Thailand	$12,000 – $25,000	Affordable, but fewer centers for complex hematology cases

Why India Is More Affordable?

• Lower hospital infrastructure and workforce costs
• Government-regulated drug pricing, including access to affordable generic Rituximab and targeted therapies
• Efficient healthcare delivery, reducing unnecessary tests or extended hospital stays
• Specialized oncology centers offering bundled treatment packages for international patients

High Value Without Compromise

Although the absolute cost in India is lower, international patients still receive:

• Expert consultation from hematologists and medical oncologists
• Personalized treatment planning based on the latest global guidelines
• Access to immunotherapy and transplant facilities
• Dedicated international patient services for smooth coordination

In short, patients save 60–80% on treatment costs while benefiting from timely, expert-led care that matches or exceeds what is offered in high-income countries.

Factors Affecting the Cost of Non-Hodgkin Lymphoma Treatment in India

While India is known for offering affordable cancer care, the actual cost of treating non-Hodgkin lymphoma varies significantly based on individual patient needs. 

• Type and Subtype of Lymphoma: The specific type of NHL—whether it's an indolent lymphoma like Follicular Lymphoma or an aggressive form like Diffuse Large B-Cell Lymphoma—determines the intensity of treatment. Slow-growing forms may only require surveillance or mild chemotherapy, while aggressive cases need complete chemotherapy, radiation, or even stem cell transplant, increasing the overall cost.
• Stage of Disease at Diagnosis: Patients with early-stage NHL often need fewer cycles of chemotherapy and shorter hospital stays. In contrast, advanced-stage disease typically involves additional investigations, longer treatment durations, and more supportive care, all of which increase total expenses.
• Choice of Medications and Regimen: The selection of medications plays a significant role in determining treatment costs. Generic Rituximab is affordable, while biosimilars and branded versions are more expensive. Advanced therapies like Ibrutinib or Venetoclax may cost over ₹1,00,000 per month. Stem cell transplantation also requires high-cost chemotherapy agents for conditioning. Patients who are eligible for standard R-CHOP tend to spend less than those on targeted or salvage therapy regimens.
• Number of Chemotherapy or Immunotherapy Cycles: Most patients receive 6–8 chemotherapy cycles; however, additional cycles may be necessary based on the response. Relapsed or refractory cases often undergo second-line treatments or bone marrow transplant, increasing both medication and hospitalization costs.
• Room Category and Inpatient Stay: Patients can choose from general wards, semi-private rooms, private deluxe rooms, or executive suites. Room rent, nursing charges, and food services vary by category. Post-chemotherapy observation or stem cell transplant may require prolonged hospitalization or ICU, adding to the final bill.
• Post-Treatment Monitoring and Follow-Up: Even after completing active treatment, patients need regular follow-ups, PET/CT scans, and blood tests to check for remission or recurrence. These are usually not included in initial treatment packages and should be factored into long-term financial planning.

Why Choose India for Non-Hodgkin Lymphoma Treatment?

For international patients diagnosed with non-Hodgkin lymphoma, India provides a unique combination of medical expertise, modern infrastructure, and personalized attention that few other countries can match.

• Globally Trained Oncologists and Hematologists: One of the strongest reasons to consider India is the availability of internationally trained oncologists who are deeply experienced in managing various forms of lymphoma. Specialists like Dr. Ankur Bahl have treated hundreds of complex blood cancer cases and are recognized for adhering to globally accepted treatment protocols.
• Advanced Treatment Technologies: India's top cancer hospitals are equipped with advanced diagnostic and treatment technologies. These include high-resolution PET-CT scans, immunophenotyping labs, bone marrow transplant units, and access to the latest chemotherapy, immunotherapy, and targeted drugs. 
• Cost Savings Without Quality Compromise: Despite this high level of medical sophistication, the cost of treatment remains significantly lower, making it an accessible option for many NHL patients who might otherwise be unable to afford care in their home countries.
• Shorter Wait Times: Another significant advantage is the minimal wait time for consultations, diagnostic tests, and the initiation of treatment. Patients can typically begin chemotherapy or other therapies within just a few days of arrival, something that is especially critical for fast-growing or aggressive forms of lymphoma.

International Patient Services for Non-Hodgkin Lymphoma Treatment

India's top cancer hospitals provide dedicated services for international patients, ensuring a smooth and stress-free treatment journey. From the moment you make an inquiry until your recovery, every step is supported by a specialized international care team.

• Hospitals assist with medical visa invitations, making the documentation process easier. 
• Upon arrival, most centers offer airport pickup and drop-off, as well as assistance in finding safe, nearby accommodations that suit your budget and preferences.
• Language is not a barrier as translators and multilingual staff are available to help you communicate clearly with your doctors and nurses.
• Many hospitals also offer customized meals tailored to your dietary preferences and cultural needs.
• Before you travel, hospitals often arrange online consultations to review your reports and plan your treatment. 
• After discharge, they remain in touch through telemedicine, allowing you to continue follow-up care from your home country.

Success Rate of Non-Hodgkin Lymphoma Treatment in India

For early-stage and indolent forms of NHL, the remission rate in India exceeds 85%. Patients who respond well to initial treatment often remain disease-free for many years. Aggressive types like Diffuse Large B-Cell Lymphoma can also be cured in over 60% of cases when treated with the right chemotherapy combinations, such as R-CHOP.

Advanced treatment protocols, including immunotherapy, targeted agents such as Ibrutinib, and stem cell transplantation, have further improved survival rates. In major Indian cancer hospitals, five-year survival for curable subtypes of NHL ranges between 60% and 80%, depending on the stage at diagnosis and how the disease responds to treatment.

Moreover, India's emphasis on supportive care, post-treatment monitoring, and long-term follow-up ensures that patients maintain quality of life even after completing their therapy. With personalized care and quick access to advanced treatment, India continues to deliver results that match the best global standards.

Recovery After Non-Hodgkin Lymphoma Treatment

Recovery from non-Hodgkin lymphoma depends on several factors, including the type of lymphoma, the treatment regimen, and the patient's age and overall health. While each patient's journey is unique, most follow a general timeline that outlines the physical and emotional healing that occurs after active treatment ends.

• First 1–3 Weeks Post-Treatment: Patients typically experience fatigue, nausea, or a decline in immunity in the first few weeks after chemotherapy or immunotherapy. Blood counts may still be low, so doctors recommend rest, hydration, and taking precautions against infection. Follow-up blood tests are done during this time to check recovery progress.
• 1–3 Months After Treatment Completion: This period marks gradual physical recovery. Energy levels begin to improve, and side effects such as hair loss, changes in taste, or appetite issues start to resolve. Patients may resume light physical activities. Follow-up visits include imaging scans and clinical exams to assess treatment response.
• 3–6 Months Post-Treatment: Most patients return to near-normal routines within this timeframe. The immune system continues to strengthen, and emotional well-being begins to stabilize. If the disease is in remission, doctors begin spacing out follow-up appointments. Nutritional support and physiotherapy may be added if needed.
• 6–12 Months and Beyond: Long-term recovery involves regular monitoring to detect any recurrence. Patients who have undergone stem cell transplant may need more time for full immune recovery, sometimes up to 12–18 months. Many patients return to work, social life, and exercise with ongoing medical supervision.

Non-Hodgkin Lymphoma Treatment Protocol in India

In India, the treatment of Non-Hodgkin Lymphoma (NHL) follows globally recognized guidelines, including those from the National Comprehensive Cancer Network (NCCN) and the European Society of Medical Oncology (ESMO). Indian oncologists customize these protocols to match the patient's disease stage, subtype, age, and general health, while also balancing affordability and access to medication.

Chemotherapy Protocol (R-CHOP Regimen – Standard for DLBCL)

The R-CHOP protocol is the most widely used first-line treatment for aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma (DLBCL).

R-CHOP is administered every 21 days (1 cycle), typically for 6–8 cycles.

Medications and Dosages (per cycle):

• Rituximab – 375 mg/m² IV on Day 1
• Cyclophosphamide – 750 mg/m² IV on Day 1
• Doxorubicin (Hydroxydaunorubicin) – 50 mg/m² IV on Day 1
• Vincristine (Oncovin) – 1.4 mg/m² IV on Day 1 (max dose 2 mg)
• Prednisone – 100 mg orally daily on Days 1–5

Monitoring and Supportive Care:

• CBC and liver/kidney function tests before each cycle
• Growth factor support (G-CSF) is indicated if the risk of neutropenia is high
• Anti-nausea and hydration protocols

Response is typically evaluated after 3 or 4 cycles via PET-CT scan. If a good response is observed, treatment continues for a total of 6 cycles; however, 8 cycles may be needed for patients with bulky disease.

Bendamustine + Rituximab (BR Regimen – For Indolent Lymphomas)

It is the preferred first-line treatment for Follicular Lymphoma and other indolent NHL subtypes in older adults.

Treatment Cycle: 28-day cycle, repeated for 6–8 cycles

• Bendamustine – 90 mg/m² IV on Days 1 and 2
• Rituximab – 375 mg/m² IV on Day 1 (first cycle), then Day 1 of each cycle

Maintenance Therapy:

• Rituximab 375 mg/m² every 2 months for 2 years may be given to responders to prolong remission.

The BR regimen has fewer side effects than R-CHOP and is well-tolerated in older patients.

High-Dose chemotherapy + Stem Cell Transplant (For Relapsed/Refractory NHL)

Autologous stem cell transplant (ASCT) is the standard of care for relapsed DLBCL after salvage therapy.

Salvage Protocol Examples (pre-transplant):

• R-DHAP (Rituximab + Dexamethasone + High-dose Ara-C + Cisplatin)
• R-ICE (Rituximab + Ifosfamide + Carboplatin + Etoposide)

ASCT Protocol:

• Stem cells are collected from the patient's blood.
• Conditioning regimen: BEAM (Carmustine, Etoposide, Ara-C, Melphalan)
• Stem cells are reinfused after 5–6 days of high-dose chemo.
• Patient remains in isolation for 2–3 weeks post-transplant.

Targeted Therapy (For Select Genetic Subtypes)

Ibrutinib – Used in mantle cell lymphoma and some T-cell lymphomas

• Dose: 560 mg orally once daily until disease progression

Lenalidomide – Used in follicular or transformed NHL

• Dose: 20–25 mg orally on Days 1–21 of a 28-day cycle, often combined with Rituximab

Epcoritamab, Tafasitamab, Polatuzumab vedotin – Newer options used in specific cases, often when standard chemo fails. These are available at select centers in India.

Immunotherapy (Checkpoint Inhibitors – Rare in NHL, Select Use)

Checkpoint inhibitors, such as Nivolumab or Pembrolizumab, may be used in refractory cases, especially in primary mediastinal B-cell lymphoma.

• Nivolumab – 240 mg IV every 2 weeks
• Pembrolizumab – 200 mg IV every 3 weeks

These drugs are costly and reserved for patients with limited options after multiple lines of therapy.

Supportive Therapy

• G-CSF (Filgrastim/Lenograstim): To prevent neutropenia
• Antifungals and antivirals (e.g., fluconazole, acyclovir) to prevent infections
• Transfusions for anemia or thrombocytopenia during intensive chemo
• IV hydration, electrolyte correction, and antiemetics during chemo cycles

Patient Testimonials

Elena G., Ukraine

"After my diagnosis of Stage II Non-Hodgkin Lymphoma, I was overwhelmed and scared. A family friend recommended Fortis Gurgaon. Under Dr. Ankur Bahl's care, I received timely chemotherapy and constant support. I completed treatment four months ago, and my scans are now clear."

Mohammed A., Saudi Arabia

"The cost of treatment in my country was out of reach. I traveled to India and was treated by a wonderful team led by Dr. Bahl. The entire process, from visa help to aftercare, was smooth. I am deeply thankful for the professionalism and kindness I received."

Tariro M., Zimbabwe

"When I arrived in India, I was weak and unsure about what lay ahead. But the medical team at Fortis made me feel safe. Dr. Ankur Bahl explained each step, and the nurses cared for me like family. Today, I'm back home, healthy and grateful.