Childhood Non-Hodgkin Lymphoma
About the disease
The lymph system is found throughout the body and helps protect against infections and disease. The lymph is a fluid that travels through the lymph vessels, which are similar to blood veins. It carries white blood cells, passing through the lymph nodes, which act as filters. The spleen makes white blood cells and destroys old cells helped by the thymus, an organ where those cells grow and multiply. The tonsils also help make white blood cells.
Because the lymph system spread throughout the body, non-Hodgkin lymphoma can occur anywhere, but treatment is different for children than for adults. It is also a distinct disease from Hodgkin lymphoma, even though they both occur in the lymph system.
About five Alberta children under the age of 14 are diagnosed with non-Hodgkin lymphoma every year.
Risk factors
Risk factors are determined by analyzing the numbers of patients with cancer in a larger population and trying to find differences in the characteristics or behaviors between those individuals who develop cancer and those who do not. The Alberta Cancer Board’s Tomorrow Project, for instance, is tracking more than 50,000 Albertans over a fifty-year period to learn more about who develops cancer and why.
The causes of non-Hodgkin lymphoma are unknown, but some research suggests that a weakened immune system can increase the risk of development this disease. Exposure to certain viruses and bacteria could be a factor because they suppress the body’s ability to fight off disease and infection. Viruses that may increase the risk include: Epstein-Barr, human herpes, hepatitis C, HIV.
Other factors that may increase the risk of developing non-Hodgkin lymphoma include:
- Race – more common among whites
- Gender – more common among boys
- Organ and bone marrow transplant (which involve the use of immune-suppression drugs)
- Environmental – exposure to pesticides and herbicides
Genetic link
There is weak evidence that family history may play a role in the development of non-Hodgkin lymphoma, but only in a small percentage of cases. More study is needed.
Detection and diagnosis
Children who have non-Hodgkin lymphoma may experience respiratory problems such as shortness of breath, trouble breathing, wheezing and high-pitched breathing sounds. They may have trouble swallowing and swelling around the head or neck. It won’t hurt, but the lymph nodes in the neck, underarms, stomach or groin area can be swollen. There may be unexplained fever and weigh loss.
Diagnosis would begin with a physical exam to check for swelling or lumps. An x-ray, CT or MRI scan may be required, or a procedure called a tomography which involves injecting a dye so the organs can be seen more clearly.
A biopsy is the only way to confirm the presence of cancer. That may mean removing a small piece of tissue with a thin needle, or the removal of a lump, lymph node, bone or bone marrow for examination under a microscope.
Treatment
Treatment options for non-Hodgkin lymphoma include chemotherapy and radiation therapy, often in combination depending on the progression of the disease.
Chemotherapy is the main treatment for non-Hodgkin disease, using a drug or several drugs in combination, either taken by mouth or injected into the body, to target the cancel cells.
Bone Marrow Transplants may be needed for those children who require extremely high doses of radiation or chemotherapy because they have become resistant to treatment. Those high doses can kill healthy bone marrow, so stems cells can be taken from the patient before treatment and then reinfused (autologous) or taken from a donor whose marrow is a close match (allogeneic). The treatment is aimed at replacing diseased stem cells with healthy ones that will in turn produce healthy cells.
Radiation therapy, concentrated beams of high-energy X-rays, is sometimes used alone or in combination with chemotherapy. Internal radiation involves sealing a radioactive substance in needles, seeds or wires that are placed directly near the cancer.
Links:
Childhood Cancer Foundation
National Comprehensive Cancer Network (U.S.) guide to treatment decisions with links to other sites
National (U.S.) Cancer Institute guide to childhood cancers
Public Health Agency of Canada: government resource guide to further information
Leukemia and Lymphoma Society of Canada, with links to Childhood Cancer organizations
Childhood Cancer Net (U.S.) with links to support groups and research information:
Factors affecting prognosis
As with most cancers, the age and general health of the patient has an impact on the outcome of treatment and so does the spread of the cancer at the time of diagnosis.
Children can experience “late effects” from cancer treatment for years after it ends. For information:
National (U.S.) Cancer Institute
Learn more
Support for childhood non-Hodgkin lymphoma patients and their families
- Psychosocial and spiritual support, Edmonton,
Cross Cancer Institute
- Phone: (780) 432-8703 or 8704
- Psychosocial and spiritual support, Calgary,
Holy Cross site of the Tom Baker Cancer Centre
- Compassion House
How you can help
Other Resources
Canadian Cancer Society
Child Cancer Net
