Non-Hodgkin lymphoma (NHL) is a general term for cancers of the lymphoid system (also known as lymph or lymphatic system). The lymphoid system is part of the immune system that protects the body from infections. Cells called B and T lymphocytes can be found in lymph glands (nodes), the spleen, the tonsils, adenoids, and many other organs and tissues including the intestinal tract. It is these cells in lymph glands and organs that are abnormal or malignant in NHL.
There are more than a dozen types of NHL, but the following are the most common types seen in children and adolescents:
Approximately 7% of all childhood cancers are NHL. NHL occurs more frequently with increasing age. Twice as many boys than girls are diagnosed with NHL.
What causes non-Hodgkin lymphoma?
We don't know the cause of most cases of NHL, but we do know that B and T lymphocytes of the immune system are prone to making mistakes or developing variations in their “message” to the body, these mistakes are known as mutations, Sometimes mutations can lead to new cells multiplying without older cells dying off as is the normal process. These lymphocytes can grow locally (in lymph nodes or tonsils), or spread to distant sites in the body through the bloodstream or lymph vessels. These are typical characteristics of cancer.
What are the symptoms of non-Hodgkin lymphoma?
Symptoms of non-Hodgkin lymphoma include:
Enlarged lymph nodes which may cause swelling in the neck, underarm or groin. Sometimes the lymph nodes involved are in the stomach or intestines so there may be swelling of the abdomen abdominal pain or constipation
Difficulty breathing, such as wheezing, shortness of breath, or high-pitched breathing sounds may occur due to enlarged or swollen lymph glands in the chest (mediastinum).
Children may have pain, unexplained fever, weight loss or night sweats as well.
What are the factors affecting the type of treatment and chance of cure?
Factors affecting the treatment type and cure rate include:
Tumor stage: Earlier stage tumors (I or II) usually have a better outcome than higher stage tumors (III or IV).
Extent or volume of the cancer: Size of the primary tumor, whether or not lymph nodes are involved and to what parts of the body the tumor has spread will determine the treatment needed and the response to therapy.
Lymphocyte biology: There are a number of different types of Non-Hodgkin Lymphoma. The lymphocytes of patients with different types of NHL have a different appearance under the microscope. Each of the specific types of NHL requires a specific treatment approach.
June 2008