Non-Hodgkin Lymphoma (NHL) in Children

Non-Hodgkin Lymphoma (NHL) in Children

The body’s lymphatic system assists the body immune system filter out bacteria, infections, and other undesirable or harmful substances. The lymphatic system includes:

  • the lymph nodes (also called lymph glands)
  • thymus
  • spleen
  • tonsils
  • adenoids
  • bone marrow

Channels– called lymphatics or lymph vessels– connect the parts of the lymphatic system.

Lymphoma is a kind of cancer that begins in lymphatic tissue. There are numerous different types of lymphomas. Some involve lymphoid cells and are grouped under the heading of Hodgkin lymphoma. All other forms of lymphoma fall under the non-Hodgkin lymphoma grouping.

  • Non-Hodgkin lymphoma (in some cases called NHL, or just lymphoma) is a cancer that begins in cells called lymphocytes, which are part of the body’s body immune system. NHL is not common in children, but it can happen.

Hodgkin Lymphoma

Lymphomas that include a kind of cell called a Reed-Sternberg cell are categorized as Hodgkin lymphoma. Various types of Hodgkin lymphoma are classified based upon how the cancerous tissue looks under a microscopic lense. Hodgkin lymphoma affects about 3 out of every 100,000 Americans, many commonly during early and late adulthood (in between ages 15 and 40 and after age 55).

The most typical first symptom of Hodgkin lymphoma is a painless enlargement of the lymph nodes (a condition referred to as swollen glands) in the neck, above the collarbone, in the underarm area, or in the groin.

If Hodgkin lymphoma involves the lymph nodes in the center of the chest, pressure from this swelling may cause an inexplicable cough, shortness of breath, or issues in blood flow to and from the heart.

Some individuals have other symptoms consisting of tiredness (fatigue), poor appetite, itching, or hives. Unusual fever, night sweats, and weight loss are likewise typical.

Non-Hodgkin Lymphoma (NHL)

Non-Hodgkin lymphoma (NHL) can take place at any age during youth, however is unusual prior to age 3. NHL is slightly more typical than Hodgkin disease in kids below 15 years of ages.

In non-Hodgkin lymphoma, there is deadly (cancerous) growth of particular types of lymphocytes (a type of white blood cell that collects in the lymph nodes).

Non-Hodgkin Lymphoma (NHL) in Children

Risk for Youth Lymphoma

Both Hodgkin lymphoma and non-Hodgkin lymphoma tend to take place more frequently in people with specific severe immune deficiencies, including:

  • those with inherited immune flaws (flaws gave by parents)
  • grownups with human immunodeficiency infection (HIV) infection
  • those treated with immunosuppressive drugs after organ transplants (these strong drugs help keep back the activity of the immune system)

Kids who have actually had either radiation therapy or chemotherapy for other types of cancer seem to have a higher risk of developing lymphoma later on in life.

Routine pediatric examinations can sometimes spot early symptoms when lymphoma is linked to an inherited immune issue, HIV infection, treatment with immunosuppressive drugs, or prior cancer treatment.

No lifestyle aspects have been absolutely linked to youth lymphomas. Generally, neither parents nor kids have control over what causes lymphomas. The majority of cases are due to noninherited mutations (errors) in the genes of growing blood cells.

Medical diagnosis

Physicians will check a child’s weight and do a physical examination to look for enlarged lymph nodes and signs of infection. Utilizing a stethoscope, they’ll analyze the chest and feel the abdominal area to check for pain, organ enhancement, or fluid accumulation.

In addition to the physical exam, medical professionals take a medical history by asking about the child’s previous health, his/her family’s health, and other concerns.

In some cases, when a child has an enlarged lymph node for no apparent reason, the doctor will enjoy the node carefully to see if it continues to grow. The doctor may recommend antibiotics if the gland is thought to be infected by bacteria, or do blood tests for particular types of infection.

If the lymph node remains bigger, the next step is a biopsy (removing and examining tissue, cells, or fluids from the body). Biopsies are likewise needed for lymphomas that involve the bone marrow or structures in the chest or abdominal area.

The biopsy may be done utilizing a thin hollow needle (this is called needle goal). Or, a little surgical cut may be made while the patient is under general anesthesia. Often, a biopsy may require a surgical excision under anesthesia. This implies a piece of the lymph node or the entire lymph node is eliminated.

In the laboratory, tissue samples from the biopsy are analyzed to figure out the particular type of lymphoma. Besides these fundamental lab tests, more sophisticated tests are usually done, including genetic research studies, to distinguish between particular types of lymphoma.

To identify which areas of the body are impacted by lymphoma, these tests are likewise used:

  • blood tests, including complete blood count (CBC)
  • blood chemistry, including tests of liver and kidney function
  • bone marrow biopsy or aspiration
  • lumbar puncture (spinal tap) to look for cancer spread to the main nerve system (brain and spine)
  • ultrasound
  • computed tomography (CT) of the chest and abdominal area, and sometimes X-rays
  • magnetic resonance imaging (MRI)
  • bone scan, gallium scan, and/or positron emisson tomography (FAMILY PET) scan (when a radioactive material is injected into the bloodstream to try to find proof of tumors throughout the body)

These tests help doctors choose which kind of treatment to use.


Treatment of childhood lymphoma is largely determined by staging. Staging is a way to categorize or categorize patients inning accordance with how substantial the disease is at the time of diagnosis.

Chemotherapy (the use of highly potent medical drugs to kill cancer cells) is the main form of treatment for all types of lymphoma. In particular cases, radiation (utilizing high-energy rays to eliminate cancer cells and keep them from growing and multiplying) might likewise be used.

Short-Term and Long-Term Side Effects

Chemotherapy for lymphoma affects the bone marrow, triggering anemia and bleeding issues, and increases a person’s risk for severe infections.

Chemotherapy and radiation treatments have numerous other side effects– some short-term (such as loss of hair, changes in skin color, increased infection risk, and nausea and vomiting) and some long-term (such heart and kidney damage, reproductive problems, thyroid problems, or the development of another cancer later on in life).

Parents must discuss all potential side effects with their child’s care group.


Although many kids recover from lymphoma, some with severe lymphoma will have a regression (reappearance of the cancer). For these children, bone marrow transplants and stem cell transplants are frequently among the treatment alternatives.

During a bone marrow/stem cell transplant, chemotherapy with or without radiation therapy is given to eliminate malignant cells. Then, healthy bone marrow/stem cells are presented into the body. These healthy cells can produce leukocyte that will help the child fight infections.

New Treatments

New treatments for youth lymphomas include several different types of immune therapy, specifically using antibodies to deliver chemotherapy medications or radioactive chemicals directly to lymphoma cells. (Antibodies are proteins made by the body immune system to eliminate bacteria, infections, and toxins.) This direct targeting of lymphoma cells can help a person avoid the side effects that happen when chemotherapy and radiation treatments damage typical, noncancerous body tissues.

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