Lymphoma

What is Lymphoma in Children?

Lymphoma is a cancer that begins in the lymphatic system. Lymphoma affects the lymph nodes, thymus, liver and spleen. Sometimes, it may spread to other organs such as the lungs, brain, bone and bone marrow.

Lymphoma is divided into “stages,” depending upon how many places the lymphomas are in the body.

There are two major groups of lymphoma in children:

1. Hodgkin’s disease, and
2. non-Hodgkin’s lymphoma

Hodgkin’s disease, also called Hodgkin's lymphoma, has four major subtypes:

1. lymphocyte predominance,
2. nodular sclerosis,
3. mixed cellularity, and
4. lymphocyte-depleted

Non-Hodgkin’s lymphoma has four subcategories:

1. Burkitt’s lymphoma,
2. lymphoblastic lymphoma,
3. large cell lymphoma, and
4. anaplastic large cell lymphoma

Other Types of Lymphoma in Children

• Burkitt's lymphoma is an aggressive (fast-growing) type of B-cell non-Hodgkin lymphoma that occurs most often in children and young adults. The disease may affect the jaw, central nervous system, bowel, kidneys, ovaries, or other organs. There are three main types of Burkitt lymphoma (sporadic, endemic, and immunodeficiency related). Sporadic Burkitt lymphoma occurs throughout the world, and endemic Burkitt lymphoma occurs in Africa. Immunodeficiency-related Burkitt lymphoma is most often seen in AIDS patients.
• Anaplastic large cell lymphoma is an aggressive (fast-growing) type of non-Hodgkin lymphoma that is usually of the T-cell type. The cancer cells express a marker called CD30 or Ki-1 on the surface, and may appear in the lymph nodes, skin, bones, soft tissues, lungs, or liver. Also called ALCL.
• B cell non-Hodgkin lymphoma is a type of immune cell that makes proteins called antibodies, which bind to microorganisms and other foreign substances, and help fight infections. A B cell is a type of white blood cell. Also called B lymphocyte.
• Diffuse large B-cell lymphoma is a type of B-cell non-Hodgkin lymphoma (cancer of the immune system) that is usually aggressive (fast-growing). It is the most common type of non-Hodgkin lymphoma, and is marked by rapidly growing tumors in the lymph nodes, spleen, liver, bone marrow, or other organs. Other symptoms include fever, night sweats, and weight loss. There are several subtypes of diffuse large B-cell lymphoma.

What causes childhood lymphoma?

• The Epstein-Barr virus is associated with some cases of Hodgkin’s disease and Burkitt’s lymphoma. Causes for other lymphomas are unknown.
• Lymphoma is the third most common cancer in children, following leukemia and brain tumors.
• Children and young adults between the ages of 0-19 can get lymphomas. Adults can get lymphomas also.
• Frequency of non-Hodgkin’s lymphoma is slowly increasing, but no one knows why.
• Non-Hodgkin’s lymphoma and Hodgkin’s disease occur with increased frequency in patients with HIV/AIDS or congenital immune deficiencies (like severe combined immune deficiency, or after organ or bone marrow transplants.)

What is the treatment for lymphoma?

Therapies vary depending on the disease and the extent of disease or stage. On average, for extensive disease, 6-8 months of intensive chemotherapy is given. An exception is that treatment for lymphoblastic lymphomas requires two years of treatment. Radiation therapy is only used for Hodgkin’s disease, along with chemotherapy. Treatment for Non-Hodgkin’s lymphoma is chemotherapy. Less extensive stage diseases generally require less therapy.

What is the prognosis for children and adolescents diagnosed with lymphoma?

In children 0-19 years of age with Non-Hodgkin lymphoma, the five-year survival rate is almost 80 percent. This represents a significant improvement from the 1970s, where most children with non-Hodgkins lymphoma did not live five years after diagnosis. Expectations for children with Hodgkins lymphoma are better.