We understand how difficult a diagnosis of non-Hodgkin lymphoma can be, both for your child and for your whole family. That's why our physicians are focused on family-centered care: From your first visit, you'll work with a team of professionals who are committed to supporting all of your family's physical and psychosocial needs. We'll work with you to create a care plan that's best for your child.
There are several treatment options, which may or may not include a combination of therapies.
What are some guiding treatment strategies for treating non-Hodgkin lymphoma?
A major factor for treatment strategy is whether the cancer is isolated (localized) to a specific part of the body, or if it has spread to different parts of the body (disseminated). Another consideration is the specific kind of non-Hodgkin lymphoma.
- limited chemotherapy for localized non-Hodgkin lymphoma
- multiple chemotherapy drugs (combination chemotherapy) and chemotherapy injected into the spinal column (CNS prophylaxis) for disseminated non-Hodgkin lymphoma
Another factor is whether or not the cancer is a cancer that has returned (recurrent). If your child has recurrent non-Hodgkin lymphoma, treatment might include:
- high-dose chemotherapy with stem cell transplant
- combination chemotherapy
What is treatment like?
The most common form of treatment is chemotherapy, in which drugs are used to kill cancerous cells, but unfortunately can sometimes damage healthy cells as well. If intensive chemotherapy is needed, your child will mostly likely be extremely tired and not be able to attend school or participate in athletics. Low stage non-Hodgkin lymphoma does not impact the well being of your child or his ability to attend school.
Children with non-Hodgkin lymphoma are usually treated with chemotherapy.
Chemotherapy is drug regimen that is either designed to kills cells or prevents them from dividing and spreading. There are several ways to take chemotherapy drugs such as:
- systemic chemotherapy
- attacks cancer that has spread throughout the body
- consumed orally or injected in a vein or muscle or under the skin
- intrathecal chemotherapy
- injected into the spinal column,
- intrathecal chemotherapy can be given to treat lymphoma cells found in the spinal fluid or to prevent lymphoma from spreading to the spinal fluid
- using two or more chemotherapy drugs, also known as combination chemotherapy
- high-dose chemotherapy with stem cell transplant
- Chemotherapy is used to eliminate cancerous blood cells, and then immature blood stem cells are infused into the patient.
- Infused stem cells grow into healthy blood cells.
- Stem cells come from the bone marrow or blood of the patient (autologous) or a donor (allogenic) with genetically similar blood.
Are there any side effects of chemotherapy?
Chemotherapy is the use of strong drugs throughout the bloodstream designed to kill cancer cells. The side effects are systemic (affecting a child's whole body), and most commonly include nausea and vomiting, but may also include sores in the mouth or gastrointestinal track. Another side effect is myelosuppression, which is when there are a low number of healthy blood cells, including red blood cells, white blood cells and platelets. Myelosuppression increases a child's risk for infection, anemia and low platelet levels which can lead to minor bleeding, such as nose bleeds or bleeding from brushing teeth.
Radiation is very rarely used to treat children with non-Hodgkin lymphoma. There are several ways to have radiation such as:
- using a machine outside of the body to send radiation towards the cancer (external radiation)
- packaging radioactive substances in needles, wires, seeds or catheters to be directly placed on the cancer (internal radiation)
- using radiation to protect the central nervous system (CNS prophylaxis)
Monoclonal antibody therapy(clinical trial phase)
Currently being tested for effectiveness, monoclonal antibody therapy is a type of targeted therapy that is designed to only attack cancerous cells, and not harm normal cells. These antibodies are made in the laboratory, and can identify and “fix” specific abnormalities on cancerous cells. It has several capabilities such as:
- blocking growth signaling chemicals (growth factor) within the cancer cell to block the cancerous cells from receiving drug, and essentially “starving” the cancer from a lack of nutrients in the blood.
- serving as a transport to deliver drugs, toxins or radioactive materials directly to cancer cells
- It is not currently known if adding monoclonal antibody treatment to standard chemotherapy regimens will improve the cure rate in childhood non-Hodgkin lymphoma.
Stem cell transplant
If your child's lymphoma is completely resistant to initial treatment or recurs despite initial treatment, a stem cell transplant may be an option. In a stem cell transplant, the transplanted bone marrow is usually the patient's own (autologous), rather than coming from someone else.
Complementary and alternative medicines
Our cancer treatment center has specialists who deliver complementary or alternative medicines. These treatments, which may help control pain and side effects of therapy, include:
- therapeutic touch
- herbal supplements
- dietary recommendations
Talk to your child's physician about whether complementary or alternative medicine might be a good option for your child.
What are some factors that affect my child's chance of recovery (prognosis)?
Some factors for recovery include the stage of cancer, the patient's general health, how far it has spread (metasize) Overall, however, there is little difference in the chance of cure based on spread or type of non-Hodgkin lymphoma. These factors are important in choosing the best treatment.
What's the long-term outlook for a child with non-Hodgkin lymphoma?
Each child's situation is different, and much depends on getting an exact diagnosis and using it to formulate the proper treatment plan. With that said, overall, the long-term outlook is excellent, and more than 80 percent of children with non-Hodgkin lymphoma being cured and can resume a normal full life, returning to school, social activities and athletics usually within a year after treatment has finished.
What will long-term care for my child be like?
It's important for your child to visit a survivorship clinic every year to:
- manage disease complications
- screen for recurrence of cancer and/or secondary cancers
- manage late effects of treatment
A typical follow-up visit may include some or all of the following:
- physical exam
- laboratory testing
- imaging scans
Through the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute, childhood cancer survivors receive a comprehensive follow-up evaluation from their cancer care team.
Coping and support
Treatment and recovery for non-Hodgkin lymphoma can be especially challenging for you and your whole family, as well as for your child. Learn more about the different patient and family resources available to your whole family at the Dana-Farber/Boston Children's.
Keep your family and friends up to date during your child's treatment by creating a free Children's CarePage.