Lymphomas are cancers of the lymphatic system. This system drains excess fluid from the tissue. It also helps protect against infections. Non-Hodgkin’s lymphoma is a general name that applies to many types of lymphomas, which are based on:
- The type of cell that is involved
- The patterns of growth
In general, there are two main groups:
- Slow growing lymphomas
- Aggressive lymphomas
These cancers are different from Hodgkin’s lymphoma. This is another type of cancer that affects the lymphatic system.
The Lymphatic System
The exact cause is not known. Mutations in genes may be related to this cancer.
Some risk factors include:
- History of chemotherapy and radiation therapy
- Infections involving the immune system, such as HIV/AIDS or Epstein-Barr virus
- Chronic hepatitis C infection
- Genetic conditions, such as ataxia telangiectasia, X-linked lymphoproliferative disease, or Wiskott-Aldrich syndrome
- A parent had non-Hodgkin lymphoma, especially if they had it at an early age
Symptoms may vary greatly in each child. Symptoms may include:
- Painless swelling of the neck, underarm, groin, or any other lymph node area
- Unexplained fever
- Sore throat
- Constant fatigue
- Unexplained weight loss
- Itchy skin, especially on the legs and feet
- Bone and joint pain
- Chest pain or shortness of breath
If your child has any of these symptoms, tell the doctor right away.
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. It will include an exam of the lymph nodes. Most enlarged or swollen lymph nodes result from an infection.
If swelling persists, the doctor may order more tests, such as:
- Blood and urine tests
- Chest x-ray —takes a picture of structures inside the chest to look for enlarged lymph nodes
- CT scan —makes pictures of structures inside the body to look for lymphomas in the abdomen, head, pelvis, chest, and neck
- Lymph node biopsy —to look for cancer
- Bone marrow aspiration and biopsy —a small amount of bone marrow (aspiration) and bone are removed to determine the extent of lymphoma
- Spinal tap —a small amount of cerebrospinal fluid is removed and examined to determine the extent of lymphoma
- PET scan —radioactive solution is injected into a vein so that a special camera can look for lymphoma throughout the body
Treatment depends on the stage of the cancer and its type. Talk with the doctor and the healthcare team about the best plan for your child. Treatment options include:
Chemotherapy and Radiation Therapy
Chemotherapy involves the use of drugs to kill cancer cells. The drugs enter the bloodstream, then travel through the body killing mostly cancer cells. With radiation therapy, radiation is directed at the tumor to kill the cancer cells.
Your child may have a transplant procedure, such as:
- Bone marrow transplantation —Bone marrow is removed, treated, and frozen. Large doses of chemotherapy and/or radiation therapy are applied to kill the cancer cells. After treatment, the bone marrow is replaced via a vein. Marrow may also be donated from a healthy donor.
- Peripheral stem cell transplant—Stem cells are very immature cells that produce blood cells. They are removed from circulating blood before chemotherapy or radiation treatment. The cells are replaced after treatment. These cells can develop new healthy cells.
These medicines are designed after the body's natural cancer-fighting mechanisms. They increase or restore the body’s natural defenses against cancer. One type of biological therapy, interferons, interferes with the division of cancer cells and can slow tumor growth.
Sometimes a drug or antibody that is directed at the lymphoma is linked to a radioactive substance. It will deliver a focused dose of radiation to the tumor.
There is no known way to prevent this form of cancer.
American Cancer Society
Leukemia and Lymphoma Society
Canadian Cancer Society
Lymphoma Foundation Canada
American Cancer Society. Non-Hodgkin’s lymphoma in children. American Cancer Society website. Available at: http://www.cancer.org/Cancer/Non-HodgkinLymphomainChildren/DetailedGuide/non-hodgkin-lymphoma-in-children-non-hodgkin-lymphomain-children. Updated July 8, 2009. Accessed July 7, 2010.
Children’s Hospital of Wisconsin. Non-Hodgkin’s lymphoma. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/21526/router.asp. Accessed July 7, 2010.
DynaMed Editorial Team. Non-Hodgkin’s lymphoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 25, 2010. Accessed July 7, 2010.
McCoy K. Adult non-Hodgkin’s lymphoma. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated October 2009. Accessed July 7, 2010.
2/5/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kharazmi E, Fallah M, Sundquist K, et al. Familial risk of early and late onset cancer: nationwide prospective cohort study. BMJ. 2012;345:e8076.
Last reviewed March 2014 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.