Non-Hodgkin lymphoma in children
Non-Hodgkin lymphoma (NHL) is cancer of the lymph tissue. Lymph tissue is found in the lymph nodes, spleen, tonsils, bone marrow, and other organs of the immune system. The immune system protects us against diseases and infections.
This article is about NHL in children.
Lymphoma - non-Hodgkin - children; Lymphoblastic lymphoma - children; Burkitt lymphoma - children; Large cell lymphomas - children, Cancer - non-Hodgkin lymphoma - children; Diffuse large B-cell lymphoma - children; Mature B cell lymphoma - children; Anaplastic large cell lymphoma
NHL tends to occur more often in adults. But children do get some types of NHL. NHL occurs more often in boys. It usually doesn't occur in children younger than age 3.
The exact cause of NHL in children is not known. But, the development of lymphomas in children has been associated with:
There are many types of NHL. One classification (grouping) is by how fast the cancer spreads. The cancer may be low grade (slow growing), intermediate grade, or high grade (fast growing).
NHL is further grouped by:
Symptoms depend on which area of the body is affected by the cancer and how fast the cancer is growing.
Symptoms may include:
Exams and Tests
The health care provider will take your child's medical history. The provider will do a physical exam to check for swollen lymph nodes.
The provider may perform these lab tests when NHL is suspected:
A lymph node biopsy confirms the diagnosis for NHL.
If a biopsy shows that your child has NHL, more tests will be done to see how far the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up.
Immunophenotyping is a laboratory test used to identify cells, based on the types of antigens or markers on the surface of the cell. This test is used to diagnose the specific type of lymphoma by comparing the cancer cells to normal cells of the immune system.
You may choose to seek care at a children's cancer center.
Treatment will depend on:
Chemotherapy is most often the first treatment:
Your child may also receive radiation therapy using high-powered x-rays at cancer-affected areas.
Other treatments may include:
Having a child with cancer is one of the hardest things you will ever deal with as a parent. Explaining what it means to have cancer to your child will not be easy. You will also need to learn how to get help and support so you can cope more easily.
Having a child with cancer can be stressful. Joining a support group where other parents or families share common experiences may help ease your stress.
Most forms of NHL are curable. Even late stages of NHL are curable in children.
Your child will need to have regular exams and imaging tests for years after treatment to make sure the tumor does not come back.
Even if the tumor comes back, there is a good chance of a cure.
Regular follow-ups will also help the health care team check for signs of the cancer returning and for any long-term treatment effects.
Treatments for NHL may have complications. Side effects of chemotherapy or radiation therapy may appear months or years after treatment. These are called "late effects." It is important to talk about treatment effects with your health care team. What to expect in terms of late effects depends on the specific treatments your child receives. The concern of late effects must be balanced by the need to treat and cure the cancer.
When to Contact a Medical Professional
Call your child's provider if your child has swollen lymph nodes with unexplained fever that does not go away or has other symptoms of NHL.
If your child has NHL, call the provider if your child has a persistent fever or other signs of infection.
American Cancer Society website. Non-Hodgkin lymphoma in children. www.cancer.org/cancer/childhood-non-hodgkin-lymphoma.html. Updated August 1, 2017. Accessed August 22, 2018.
Hochberg J, Giulino-Roth L, Cairo MS. Lymphoma. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 496.
National Cancer Institute website. Childhood non-Hodgkin lymphoma treatment (PDQ) - health professional version. www.cancer.gov/types/lymphoma/hp/child-nhl-treatment-pdq. Updated March 30, 2018. Accessed August 22, 2018.
Review Date: 7/26/2018
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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