Last Modified : 2006-07-24
The lymph system is part of the immune system and is made up of the following:
Because lymph tissue is found throughout the body, childhood non-Hodgkin’s lymphoma can begin in almost any part of the body. Cancer can spread to the liver and many other organs and tissues.
Non-Hodgkin’s lymphoma can occur in both adults and children. Treatment for children is different than treatment for adults. (See the PDQ summary on Adult Non-Hodgkin’s Lymphoma Treatment for more information.)
There are three major types of childhood non-Hodgkin’s lymphoma.The specific type of lymphoma is determined by how the cells look under a microscope. The 3 major types of childhood non-Hodgkin’s lymphoma are:
These and other symptoms may be caused by childhood non-Hodgkin’s lymphoma. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
The following tests and procedures may be used:
The prognosis (chance of recovery) and treatment options depend on:
The process used to find out if cancer has spread within the lymph system or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Some of the tests that are used to diagnose childhood non-Hodgkin’s lymphoma are also used to stage the disease. The following tests and procedures may be used in the staging process:
In stage I childhood non-Hodgkin’s lymphoma, cancer is found in a single area or lymph node outside of the abdomen or chest.
Stage IIIn stage II childhood non-Hodgkin’s lymphoma, cancer is found:
In stage III childhood non-Hodgkin’s lymphoma, cancer is found:
In stage IV childhood non-Hodgkin’s lymphoma, cancer is found in the bone marrow, brain, or spinal cord. Cancer may also be found in other parts of the body.
Recurrent childhood non-Hodgkin’s lymphoma is cancer that has recurred (come back) after it has been treated. Childhood non-Hodgkin’s lymphoma may come back in the lymph system or in other parts of the body.
Different types of treatment are available for children with non-Hodgkin’s lymphoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial should be considered. Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Children with non-Hodgkin’s lymphoma should have their treatment planned by a team of doctors with expertise in treating childhood cancer.Your child’s treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist may refer you to other pediatric doctors who have experience and expertise in treating children with non-Hodgkin’s lymphoma and who specialize in certain areas of medicine. These may include the following specialists:
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column (intrathecal chemotherapy), an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. Intrathecal chemotherapy may be used to treat childhood non-Hodgkin’s lymphoma that has spread, or may spread, to the brain. When used to prevent spread to the brain, it is called CNS prophylaxis. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Combination chemotherapy is treatment using 2 or more anticancer drugs.
Radiation therapy (in certain patients)Radiation therapy is a cancer treatment that uses high energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
High-dose chemotherapy with stem cell transplantationThis treatment is a way of giving high doses of chemotherapy and then replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the bone marrow or blood of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.
New types of treatment are being tested in clinical trials. These include the following:Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Standard treatment of stage I and stage II childhood lymphoblastic lymphoma may include the following:
New combinations of chemotherapy are being studied in clinical trials for stage I and stage II childhood lymphoblastic lymphoma. Information about these and other ongoing clinical trials is available from the NCI Web site.
Standard treatment of stage III and stage IV childhood lymphoblastic lymphoma may include the following:
New combinations of chemotherapy are being studied in clinical trials for stage III and stage IV childhood lymphoblastic lymphoma. Information about these and other ongoing clinical trials is available from the NCI Web site.
Standard treatment of recurrent childhood lymphoblastic lymphoma may include the following:
New treatments are being studied in clinical trials for recurrent childhood lymphoblastic lymphoma. Information about ongoing clinical trials is available from the NCI Web site.
Standard treatment of stage I and stage II childhood small noncleaved cell lymphoma (Burkitt’s and non-Burkitt’s) may include the following:
New treatments are being studied in clinical trials for stage I and stage II childhood small noncleaved cell lymphoma. Information about ongoing clinical trials is available from the NCI Web site.
Standard treatment of stage III and stage IV childhood small noncleaved cell lymphoma (Burkitt’s and non-Burkitt’s) is usually combination chemotherapy with CNS prophylaxis (intrathecal chemotherapy).
One of the treatments being studied in clinical trials for stage III and stage IV childhood small noncleaved cell lymphoma (Burkitt’s and non-Burkitt’s) is monoclonal antibody therapy combined with chemotherapy. Information about this and other ongoing clinical trials is available from the NCI Web site.
Standard treatment of recurrent childhood small noncleaved cell lymphoma may include the following:
One of the treatments being studied in clinical trials for recurrent childhood small noncleaved cell lymphoma is monoclonal antibody therapy combined with chemotherapy. Information about this and other ongoing clinical trials is available from the NCI Web site.
Standard treatment of stage I and stage II childhood large cell lymphoma may include the following:
New treatments are being studied in clinical trials for stage I and stage II childhood large cell lymphoma. Information about ongoing clinical trials is available from the NCI Web site.
Standard treatment of stage III and stage IV childhood large cell lymphoma is usually combination chemotherapy with CNS prophylaxis (intrathecal chemotherapy).
One of the treatments being studied in clinical trials for stage III and stage IV childhood large cell lymphoma is monoclonal antibody therapy combined with chemotherapy. Information about this and other ongoing clinical trials is available from the NCI Web site.
Standard treatment of recurrent childhood large cell lymphoma may include the following:
Some of the treatments being studied in clinical trials for recurrent childhood large cell lymphoma include the following:
Information about these and other ongoing clinical trials is available from the NCI Web site.