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300 Longwood Avenue
Boston, MA 02115
(617) 355-6000
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My Child Has:
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Lymphoma
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Lymphoma is a term used to describe cancer that originates in the lymphoid tissue of the body's lymphoid system. The lymphoid system, which is essential to the body's defense against infection, is composed of :
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- Lymph - a clear, pale fluid that bathes cells in the body
- Lymphoid vessels - the circulatory network of small vessels that transport lymph
- Lymphoid organs - such as lymph nodes, spleen and thymus, each of which produces or stores lymphocytes.
- Lymphocytes - infection fighting white blood cells
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Typically, lymphomas in the pediatric age group are categorized as Hodgkin's and non-Hodgkin's lymphomas. In both types, cells in the lymphatic system abnormally reproduce, eventually making the body less able to fight infection and cause swelling in the lymph nodes. These cancerous cells can also spread to other organs and tissue. (A cancer cell that has spread to other organs and tissue is called "metastasis.")
Since lymph nodes are located throughout the body, the site of cancer involvement is broad. However, Hodgkin's disease typically originates in nodes of the head and neck as well as the upper mediastinum (the space in the chest that separates the lungs.) See Anatomy of the Respiratory System)
Non-Hodgkins's lymphomas are more diffuse in their site of origin, although one subtype of non-Hodgkin's lymphomas, called Burkitt's lymphoma, tends to be found in the abdomen and pelvis. Other types include: lymphoblastic lymphoma, large cell lymphoma, cutaneous or skin lymphoma, Epstein-Barr virus related lymphoma, and lymphoproliferative disorders.
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Hodgkin's lymphoma is much more rare than non-Hodgkin's lymphoma, accounting for less than 1 percent of all cases of cancer in the United States. Hodgkin's lymphoma accounts for about 5 percent of all childhood cancers and it occurs most often in people between the ages of 15 and 34, and in people over age 55. The disease, for unknown reasons, affects males more than twice as often as females.
Non-Hodgkin's lymphoma, on the other hand, is the third most common childhood cancer. It occurs most often in children between the ages of 7 and 11, but can occur at any age from infancy to adulthood. Non-Hodgkin's lymphoma affects males almost three times more often than females, and is more common among Caucasian children than among African-American children and children of other races.
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The specific cause of lymphomas is unknown. It is possible that a genetic predisposition and exposure to viral infections may increase the risk for developing this kind of malignancy. There is a slightly increased chance for Hodgkin's lymphoma to occur in siblings and cousins of patients. There has been much investigation into the association of the Epstein-Barr virus (EBV), which causes the infection mononucleosis; as well as with human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS). Both of these infectious viruses have been correlated with a greater incidence of children diagnosed with Hodgkin's lymphoma and the Burkitt's variety of Non-Hodgkin's lymphoma, although the direct link is unknown. There are many individuals; however, who have infections related to EBV and HIV that do not develop lymphoma.
The development of non-Hodgkin's lymphoma has been linked to chemotherapy and radiation therapy. Non-Hodgkin's may be a second malignancy as a result of the treatment for certain cancers. Children and adults with other hereditary abnormalities have an increased risk of developing non-Hodgkin's lymphoma, including patients with ataxia telangiectasia, X-linked lymphoproliferative disease, or the Wiskott-Aldrich syndrome. Children who have undergone solid organ transplantation also have an increased incidence of lymphoma.
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The following are the most common symptoms of lymphoma. However, each child may experience symptoms differently. Symptoms may include:
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- painless swelling of the lymph nodes in neck, chest, abdomen, underarm, or groin
- sore throat
- fever
- tiring easily (fatigue)
- weight loss, decreased appetite
- night sweats
- itching skin
- frequent viral infections (i.e. cold, flu, sinus infection)
- difficulty breathing (dyspnea) due to enlarged nodes in the chest (Hodgkin's)
- fullness in groin area from node involvement (Non-Hodgkin's)
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If your child is experiencing symptoms associated with lymphoma, the doctor will want to take complete medical history and will perform a physical examination. Other diagnostic procedures, which can include blood tests, imaging tests and biopsy, vary depending on what type of lymphoma is suspected. For information about how specific types of lymphoma are diagnosed, see entries for the following: Hodgkin's disease, Burkitt's lymphoma, lymphoblastic lymphoma, large cell lymphoma, cutaneous or skin lymphoma, Epstein-Barr virus related lymphoma, and lymphoproliferative disorders
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Specific treatment for lymphoma will be determined by your child's physician based on:
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- your child's age, overall health, and medical history
- the extent of the disease
- your child's tolerance for specific medications, procedures, or therapies
- the expectations for the course of the disease
- your opinion or preference
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For more information on treatment for specific types of lymphoma, see entries for Hodgkin's disease, Burkitt's lymphoma, lymphoblastic lymphoma, large cell lymphoma, cutaneous or skin lymphoma, Epstein-Barr virus related lymphoma, and lymphoproliferative disorders. Generally speaking, treatment for all lymphomas can involve any of the following (alone or in combination):
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- chemotherapy - a medicine that helps fight cancer
- radiation therapy - treatment with high-energy rays (such as x-rays) to kill or shrink cancer cells. The radiation may come from outside of the body (external radiation) or from radioactive materials placed directly in the tumor (internal or implant radiation).
- surgery - surgery usually plays a limited role in the treatment of lymphoma. In some instances, a child may need to have a tumor removed. This may be the case if, for example, the tumor originates in the mediastinum region, where it may compress the airway and/or the heart and major vessels. Surgery in this area may entail considerable risk, and must be carefully orchestrated between the surgeon, oncologist and anesthesiologist.
- close monitoring of blood work
- stem cell transplant - the transfusion of healthy bone marrow cells into a person, after his or her own unhealthy bone marrow has been eliminated.
- bone marrow examinations
- lumbar punctures/spinal taps - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or involvement by the tumors. CSF is the fluid that bathes your child's brain and spinal cord.
- antibiotics (to prevent or treat infections)
- supportive care (for side effects of treatment)
- long-term follow up care (to determine response to treatment, detect recurrent disease, and manage late effects of treatment)
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Prognosis greatly depends on:
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- the extent of the disease.
- the presence or absence of metastasis.
- the response to therapy.
- age and overall health of the child.
- age and overall health of the child.
- new developments in treatment.
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As with any cancer, prognosis and long-term survival can vary greatly from child to child. Every child is unique and treatment and prognosis is structured around the child. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for the child diagnosed with lymphoma. Side effects of radiation and chemotherapy, as well as second malignancies, can occur in survivors of lymphoma. New methods are continually being discovered to improve treatment and to decrease side effects.
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The information on this website should not be taken as medical advice,
which can only be given to you by your personal health care professional. |
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Copyright © Children's Hospital Boston. All rights reserved. |
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