Lymphoma – Non-Hodgkin – Childhood

Overview

Childhood non-Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system.

The lymph system is part of the immune system and is made up of the following:

• Lymph: Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors.
• Lymph vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.
• Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes grow along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.
• Spleen: An organ that makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. The spleen is on the left side of the abdomen near the stomach.
• Thymus: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.

There are four major types of childhood non-Hodgkin lymphoma.

The specific type of lymphoma is determined by how the cells look under a microscope. The 4 major types of childhood non-Hodgkin lymphoma are:

• B-cell non-Hodgkin lymphoma (Burkitt and Burkitt-like lymphoma) and Burkitt leukemia.
• Diffuse large B-cell lymphoma.
• Lymphoblastic lymphoma.
• Anaplastic large cell lymphoma.

There are other types of lymphoma that occur in children. These include the following:

• Lymphoproliferative disease associated with a weakened immune system.
• Rare non-Hodgkin lymphomas that are more common in adults than in children.

Possible signs of childhood non-Hodgkin lymphoma include breathing problems and swollen lymph nodes.

These and other symptoms may be caused by childhood non-Hodgkin lymphoma. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• Shortness of breath.
• Trouble breathing.
• Wheezing.
• High-pitched breathing sounds.
• Swelling of the head or neck.
• Trouble swallowing.
• Painless swelling of the lymph nodes in the neck, underarm, stomach, or groin.
• Fever for no known reason.
•   Weight loss for no known reason.
•   Night sweats.

Tests that examine the body and lymph system are used to detect (find) and diagnose childhood non-Hodgkin lymphoma.

Treatment

Treatment of childhood lymphoma is largely determined by staging. Staging is a way to categorize or classify patients according to how extensive the disease is at the time of diagnosis.
There are four stages of lymphoma, ranging from Stage I (cancer involving only one area of lymph nodes or only one organ outside the lymph nodes) to Stage IV (cancer has spread, or metastasized, to one or more tissues or organs outside the lymphatic system). The stage at diagnosis can guide medical professionals regarding therapy and help them predict how someone with lymphoma will do in the long term.

The most common treatment for non-Hodgkin lymphoma is chemotherapy. Chemotherapy kills or stops the growth of cancer cells. Patients are also sometimes treated with radiation therapy. In addition, some people may have surgery to remove tumors.

Side Effects

Children treated with chemotherapy or radiation for non-Hodgkin lymphoma usually experience side effects. Most are temporary — although, as with all medical treatments, each child is unique and experiences side effects differently. The severity of side effects and how long they last depends on the individual and type of medicine and treatment that the doctor prescribes.

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