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Salvage chemotherapy is chemotherapy that is given after recurrence of a tumor (relapsed disease). Both salvage and/or high-dose chemotherapy are usually considered as a treatment option for patients with aggressive non-Hodgkin's lymphoma (NHL) who either fail to respond to standard treatment (refractory disease) or whose lymphoma recurs either during or after completion of standard therapy (relapsed disease). Salvage chemotherapy involves the use of combinations of high-doses of anticancer drugs which may include:

• ESHAP: methylprednisolone, etoposide, cytarabine, cisplatin
• DHAP: cisplatin, cytarabine, dexamethasone
• EPOCH: etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin
• MIME: mesna, ifosfamide, mitoxantrone, etoposide

Although salvage chemotherapy is a treatment approach that enables doctors to try to eradicate the lymphoma cells with very high doses of anticancer drugs, the lymphoma will usually recur and may be more resistant to chemotherapy. Therefore, a common approach is to use salvage chemotherapy to reduce the amount of disease and then give "consolidation" therapy using very high doses of chemotherapy and/or total body irradiation (TBI). Unfortunately, one of the side-effects of this treatment strategy is that the combination of high doses of potent drugs also destroys the stem cells (blood-forming cells) in the bone marrow that produce red blood cells, white blood cells, and platelets. This can lead to serious, life-threatening complications such as anemia, recurrent infections, and bleeding problems. To overcome this problem, patients with non-Hodgkin's lymphoma who require high-dose chemotherapy may be considered candidates for stem cell transplantation.