collarbone). Six to 12 inches of tubing remain outside the skin in the upper chest wall. Can be left in place for months or years with low infection risk. Easy to draw blood and give drugs using standard needles without having to pierce the skin each time. Requires a small surgery to be inserted. Patients must learn to clean and take care of the external tubes to prevent infection and blockage. The tubes on the outside of the body make it more obvious that a catheter is in place. Infusaport or Portacath A catheter is surgically inserted through the subclavian vein and attached to a small reservoir (port) that lies under the skin. Nothing is visible on the outside except for a bump on the upper chest. Patients do not have to do anything to care for it; a nurse keeps the line open by “flushing” it once a month with a small amount of injected liquid. Requires surgery to be inserted. Patient must be injected through the skin covering the port with a special needle each time it is used. Can be hard to use to draw blood samples because blood clots often cause clogging. Requires another minor surgical procedure to be removed. 59 Understanding Hodgkin Lymphoma What Other Types of Drugs Are Used to Treat Patients With HL? In addition to chemotherapy, immunotherapy drugs are used to treat HL. Most of these drugs have been developed relatively recently, and ongoing studies are continually testing new drugs in these categories. What Is Immunotherapy? The term immunotherapy refers to treatments that help boost the body’s own immune response. The immune system normally patrols the body for cancer cells, and when a cancer cell is detected, the immune system launches an attack to eliminate it. However, some cancer cells can “hide” from the immune system and continue to grow in an uncontrolled manner until they form tumors or spread through the body. Immunotherapies help the immune system recognize those “hidden” lymphoma cells and eliminate them from the body. Current FDA-approved immunotherapies for HL can be subdivided into three types: monoclonal antibodies, antibody-drug conjugates, and checkpoint inhibitors as described in the next few pages. For more information, view the Immunotherapy and Lymphoma fact sheet on the Lymphoma Research Foundation’s (LRF’s) website at www.lymphoma.org/publications. What Are Monoclonal Antibodies? Plasma cells are specialized white blood cells that make proteins called antibodies. Antibodies help fight infection by recognizing and sticking to viruses, bacteria, or other foreign substances in the body. Each antibody is naturally designed to recognize one specific antigen (identifying molecule on the surface of certain cells). Monoclonal antibodies are molecules that have been engineered in a laboratory to behave differently than antibodies found naturally in our bodies. Monoclonal antibodies are specifically designed to recognize and stick to a particular antigen on the surface of certain cancer cells. Once injected in the patient, the monoclonal antibodies travel through Treatment of Hodgkin Lymphoma 60 Part 2 the blood and attach themselves to the cells that have the antigen they recognize, most of which are HL cells. This can either stop or slow down the growth of the cancer cell, or it can trigger an “alarm” that makes it easier for other cells in the immune system to recognize and destroy the cancer cell.The information in this Guide will help you when you talk to your doctor about tests and treatment. Members of your healthcare team will answer your questions and give support and any needed referrals. Let your doctor know if you want a professional healthcare interpreter who speaks your native language or uses sign language. Many times, this is a free service. The news that you have lymphoma may be a shock to you and your loved ones. You may feel sad, depressed or afraid. Keep in mind that { The number of patients who have gone into remission or have been cured is increasing each year. { New treatments are being studied in clinical trials for patients of all ages and in all stages of treatment. LLS Has Ways to Help. Treatment for lymphoma will affect your daily life for a period of time. You may want to ask friends or family members