CureSearch for Children's Cancer funds and supportstargeted and innovative children's cancer research with measurableresults, and is the authoritative source of information and resourcesfor all those affected by children's cancer.
Hodgkin lymphoma (disease) is a cancer of the lymphoid system. The lymphoid system is made up of various tissues and organs, including the lymph nodes, tonsils, bone marrow, spleen, and thymus. These organs produce, store and carry white blood cells to fight infection and disease.
Approximately 900 children and adolescents each year are diagnosed with Hodgkin disease in the United States. It has been reported in infants and very young children, but is considered rare before the age of five. The number of cases increases significantly in the second decade of life, making it most common in teenagers.
Most patients who have Hodgkin disease experience swollen lymph nodes (small tissues located throughout the body that store white blood cells to help filter out germs), called lymphadenopathy. People usually cannot feel lymph nodes unless they become swollen while fighting infection. In Hodgkin disease, the lymph nodes are usually larger than those that occur with common infections, and they do not shrink when treated with standard medications like antibiotics. The affected lymph nodes are usually found in the neck or above the collarbone, and less commonly under the arms or in the groin. The lymph nodes are usually painless, firm, rubbery, and movable in the surrounding tissue.
Evaluation begins with a complete medical history and physical examination. The physician will examine your child's lymph nodes and abdomen thoroughly. The presence of small, soft lymph nodes are less concerning than nodes that have been increasing in size or are significantly enlarged. An enlarged spleen or liver may indicate generalized disease. While a chest X-ray is usually performed prior to any biopsy, a lymph node (or rarely other site) biopsy is needed to diagnose the disease.
A standardized staging system (stages I-IV) developed for Hodgkin disease is called the Ann Arbor staging system. The stages are defined by the locations of lymph nodes in the body that are infiltrated by the cancer. The higher the stage number, the more the disease has spread throughout the lymphoid system and into other parts of the body.
Ann Arbor Staging Classification for Hodgkin Disease
Stage IV: Cancer is located in sites usually outside of the lymph nodes. When cancer is found in the lungs, liver, bone or bone marrow it is classified as Stage IV.
Only a few risk factors for Hodgkin disease are known for sure.
Epstein Barr Virus (EBV):EBV, the virus responsible for mononucleosis, is seen in the tumors of 20-50% of Hodgkin disease patients. Researchers believe that EBV is part of the cause of Hodgkin disease in these patients. However, of people who were infected with EBV in childhood or adolescence, only a few get Hodgkin lymphoma. When EBV is not found in the Hodgkin disease tumor, the virus is not part of the cause. Although researchers know that EBV infection is related to some cases of Hodgkin disease, they do not know why a few people who have been infected with EBV develop Hodgkin disease while the great majority do not.
Family history of Hodgkin disease: Siblings, parents, and children of young adults with Hodgkin lymphoma are at increased risk of having the cancer. Studies have reported an increased risk of disease especially among same-sex siblings of patients with Hodgkin disease. Although the risk of having Hodgkin disease is two-to five-times greater for siblings, the likelihood that a sibling will get the cancer remains extremely low. The clustering of cases of Hodgkin disease within families and in certain ethnic groups may suggest a genetic predisposition to the disease.
Economic status:Compared to residents of poor countries, residents of developed countries like the U.S. are less likely to develop Hodgkin disease when under 10 years old, but more likely to develop the cancer as a young adult.
Social contacts:Having fewer siblings and playmates as a child appears to increase the risk of developing Hodgkin disease as a young adult.
The type of treatment and likelihood of long-term survival depend on many factors. Almost all children with stage I or II disease can be cured; although about 1 in 10 children with early stage disease may develop new disease and need additional therapy. The recurrence of the disease decreases the chance of long-term survival.
Children with these findings may need more intense therapy and radiation therapy to have the best chance of a cure.
About Hodgkin DiseaseIn Treatment for Hodgkin DiseaseAfter Treatment for Hodgkin Disease