Childhood Lymphoma

family photo
photo by Rhoda Baer, NCI
The terms "non-Hodgkin's lymphoma" and "non-Hodgkin lymphoma" are used interchangeably on this site as are the terms "Hodgkin's disease," "Hodgkin lymphoma," and "Hodgkin's lymphoma."

Cancer continues to be the leading cause of death in children younger than 15 years old, and lymphomas are among the most common cancers seen in children. Fortunately, survival rates for childhood cancers have increased significantly over the years. Children respond to and deal with chemotherapy better than adults. Today, 96% of children diagnosed with Hodgkin's disease will survive 5 or more years, and 5-year survival rates are 86% for children diagnosed with non-Hodgkin's lymphoma (American Cancer Society, 2009).

Incidence

According to the Leukemia & Lymphoma Society, in 2008:

  • Out of 10,730 children under the age of 15 diagnosed with cancer, only 3.7% had Hodgkin's disease and 4.2% had non-Hodgkin's lymphoma.
  • Hodgkin's disease usually affects adolescents and older teenagers.
  • Hodgkin's disease is rare in young children under the age of 5.

Risk Factors

The cause of lymphoma is not known, but there is a genetic component. Incidence rates are higher for those who have a family member diagnosed with lymphoma, especially a sibling. While environmental and lifestyle factors are known to play a role in the development of cancer among adults, these factors have less of an impact on the development of childhood cancer.

Lymphoma Overview

Part of the body's immune system, the lymph system is a network of vessels and nodes that normally filters the fluid found within all tissues. Lymph nodes remove bacteria and other disease-causing organisms from the lymph fluid, and produce lymphocytes and antibodies needed to fight off infections caused by these organisms. An increase in the size of a lymph node (lymphadenopathy) indicates increased activity within the node, due to inflammation, infection, or cancer.

Malignancy (cancer) occurs when a cell's genetic code mutates, or changes, resulting in abnormal cells that grow rapidly. Lymphomas are a group of cancers originating from lymphocytes, which are white blood cells whose normal function is to fight off infections within the body. There are two major types of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).

Hodgkin's Disease (Hodgkin Lymphoma)

Hodgkin's disease is a cancer that originates from lymphocytes produced within the body's lymph system. It is the result of a mutated B-cell known as a Reed-Sternberg cell. Reed-Sternberg cells are large and abnormally shaped, with two cell nuclei.

Non-Hodgkin's Lymphoma

Non-Hodgkin's lymphoma is the result of mutated B or T-cells, and has many of the same symptoms as Hodgkin's disease. Non-Hodgkin's lymphoma tends to spread beyond lymph node areas into bone marrow, other organs, and tissues. It is described according to where it occurs in the body, and whether it is confined to one area (primary) or has spread to another area (secondary).

Diagnosis

Lymphoma will usually be diagnosed early in the disease process, since the first sign is lymph node swelling. Diagnosis of lymphoma is made from signs and symptoms, physical examination, clinical lab test and diagnostic test results, and biopsy. The presence of Reed-Sternberg cells allows for a definitive diagnosis of Hodgkin's disease.

Treatment

Lymphoma treatment regimens are based upon age, weight, general health, the presence of other diseases or conditions, and the type, grade, and stage of the cancer. Due to improved combination chemotherapy regimens with fewer side and late-term effects, the vast majority of people diagnosed will achieve a disease-free state with a low incidence of recurrence.

You will want to have your child treated at a facility that is a member of the Children's Oncology Group (COG); most are linked to a children's hospital and all are connected to a university. You, your child, and your family will have access to rehab and physical therapists, nutritionists, child life specialists, social workers, and psychologists to educate and support in addition to the medical team and state-of-the-art cancer treatment. Visit the Children's Oncology Group website for a state-by-state list of COG facilities.

While receiving a diagnosis of cancer in your child is terrible, it is important to educate both yourself and your child about the cancer and the treatment options that are currently available. You will want to tailor all communication to your child's age, but it is important to provide information to the child to avoid undue fear during this stressful time. Your entire family, including siblings of the ill child, will need support and you will also need to develop ways to provide comfort to your child during treatments.

Late Effects

After treatment, child's health may still be affected by health problems that show up after cancer treatment (sometimes years later). These are known as a "late effects." For this reason, your child's health must be closely monitored throughout the remainder of their lives. For more information, see the American Cancer Society's Childhood Cancer: Late Effects of Cancer Treatment.

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