Childhood Lymphoma: Treatment Information


A number of treatments are used for lymphoma in children, or non-Hodgkin lymphoma (NHL). Treatment plans are tailored to the specific type of NHL and its stage. Not all patients will need all of these treatments, but it is important to know that most forms of NHL in children cannot be cured with surgery alone.

Chemotherapy
Chemotherapy is the standard treatment for non-Hodgkin lymphoma. It uses medications to kill cancer cells or to prevent them from multiplying and spreading. Chemotherapy drugs can be given by mouth or through a needle into the vein or muscle. The drugs go into the bloodstream so that they reach all parts of the body (systemic) to kill cancer cells throughout the body.

Radiation therapy
Radiation therapy uses high-energy rays to kill cancer cells. Radiation is rarely needed in the overall therapy of children with NHL.

High dose chemotherapy or radiation therapy with stem cell transplantation
If the lymphoma comes back after successful treatment (relapse) or if the lymphoma does not respond to conventional treatments (refractory), higher dose chemotherapy with or without radiation followed by a stem cell transplant (rescue) may offer the best chance of cure. There are two types of transplant and the type used will depend on the specific type of lymphoma and other factors.

Monoclonal antibody therapy
Monoclonal antibody therapy uses antibodies (proteins) made in a laboratory, which are able to recognize specific cancer cells by special “markers” on the cells. The antibodies attach to these markers, causing the cancer cells to die or preventing them from multiplying. Monoclonal antibodies are given intravenously in the same way chemotherapy is given. The use of monoclonal antibodies is being evaluated for effectiveness when used in conjunction with chemotherapy. One monoclonal antibody that has proven useful in the treatment of NHL in adult patients is rituximab.

Causes of Non-Hodgkin Lymphoma
Researchers currently DO NOT know what causes non-Hodgkin lymphoma and only a few risk factors for non-Hodgkin lymphoma are known for sure.

Gender
Boys are two to three times more likely to develop non-Hodgkin lymphoma before age 20 compared to girls. For every two girls diagnosed, about five boys are diagnosed.

Race and ethnicity
Caucasian children are about 40% more likely to develop non-Hodgkin lymphoma compared to African American children.

Children with impaired immune system are more likely to develop non-Hodgkin lymphoma than other children. For example, children with HIV (the cause of AIDS) or being treated to suppress the immune system after an organ transplant are more susceptible to NHL. Children with these conditions are more at risk for non-Hodgkin lymphoma, but they account for only a small fraction of cases. Also, children with defects in their body’s ability to repair gene mutations, such as ataxia telangiectasia or Fanconi anemia, are at increased risk to develop NHL.

Participate In Research Studies
Researchers are studying the causes of non-Hodgkin lymphoma. If there is a research study "open" in COG, and your child is "eligible" you may be asked to participate. It is also possible that you may be asked to participate in more than one study.

Whether an individual is eligible for a particular study may depend on age, year of diagnosis and other information. Researchers usually must limit their study to some of these characteristics to have a scientifically valid study. For example, a study might be restricted to patients diagnosed within certain years so the researchers can locate nearly all eligible families and avoid asking parents to recall events too far in the past.

Researchers investigating the causes of non-Hodgkin lymphoma usually will interview one or both parents by telephone. During the interview, parents are asked questions about their experiences and those of their child. The purpose is to gather information that may or may not influence the risk of cancer. The researchers don’t know whether these things influence risk. They are asking the questions to find out more. Sometimes, the researcher will ask for a small biological sample from you and your child, usually cheek cells, blood or hair. Researchers may also ask for samples of dust or water from your home. The researchers use the information from the interviews and the samples to study whether genes or exposures such as medications, radon and chemicals alone or together make some people more likely to develop cancer.

The type of information you will receive about the results will be explained to you when you are asked to participate in the study. The overall results of the research study will be published to inform the public and other researchers. No study will publish any information that identifies an individual.

Research Studies

The majority of children with cancer participate in research studies. This high rate of participation has been essential to improving the cure rates for children’s cancer.

Researchers design various studies to improve treatment and advance the understanding of cancer and its causes. Clinical trials are carefully reviewed and must be approved through a formal scientific process before anyone can be enrolled. If there is a research study “open” that your child is “eligible for,” you may be asked to allow your child to participate. It is also possible that your child will be asked to participate in more than one study.

Whether an individual is eligible for a particular study may depend on age, location of the cancer, the extent of the disease and other information. Researchers usually must limit their study to some of these characteristics to have a scientifically valid study. Further, researchers must follow exactly the same restrictions throughout the study.

If your child is eligible to participate in one or more study, your doctor will discuss these with you during an initial treatment conference (also called informed consent conference). The doctor will describe the study, potential risks of participation, and other information you need to decide whether or not you would like your child to participate in the study. You always have the choice to participate or not in research studies.

If you do choose to have your child participate in a study, you doctor will explain what type of information you will receive about the results of the study. The overall results of the research study will be published to inform the public and other researchers. No study will publish any information that identifies an individual.

Visit the Clinical Trials section of this website to learn more about the various kinds of research studies.

Last updated July, 2011

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