Definition

Non-Hodgkin lymphoma is a cancer of the lymphatic system. The lymphatic system is a series of tubes and nodes that run through the body. It contains a fluid that helps fight infections and moves waste out of the body.

This cancer starts in a type of lymph cell called a lymphocyte. These cells spread throughout the lymph system. Over time, the cells will make it harder for a child's body to fight infections.

This cancer different from Hodgkin lymphoma. This is another type of cancer that affects the lymphatic system.

The Lymphatic System

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Causes

The exact cause is not known. Faulty genes may be related to this cancer.

Risk Factors

This cancer is rare in children, but it is more common in children who are older. Other things that may raise the risk are:

  • Having a weakened immune system, such as from an organ transplant
  • History of certain infections, such as hepatitis C, HIV/AIDS, or Epstein-Barr virus infection
  • Having other family members who have had non-Hodgkin lymphoma
  • Having certain genetic conditions, such as ataxia telangiectasia, X-linked lymphoproliferative disease, or Wiskott-Aldrich syndrome
  • History of radiation therapy

Symptoms

Symptoms may vary greatly in each child. Symptoms may include:

  • Painless swelling of the neck, underarm, groin, or any other lymph node area
  • Fatigue
  • Lack of hunger
  • Weight loss
  • Fever
  • Night sweating
  • Itchy skin

Diagnosis

You will be asked about your child’s symptoms and health history. A physical exam will be done. It will focus on the lymph nodes.

Blood tests may be done to look for signs of cancer.

Fluid and tissue samples may be taken to look for signs of cancer. This can be done with:

Your child's body structures may need to be viewed. This can be done with:

Treatment

Treatment depends on the stage of the disease. The stage is determined by how far the cancer has spread and what organs are affected.

Choices are:

Chemotherapy and Radiation Therapy

Chemotherapy is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells. With radiation therapy, radiation is aimed at a specific area to kill the cancer cells. Some children may have both chemotherapy and radiation.

Transplantations

Treatment and the cancer itself can damage blood and lymph cells. Transplantation will help the body rebuild these cells. Choices are:

  • Bone marrow transplantation —Bone marrow is removed, treated, and frozen. Large doses of chemotherapy and/or radiation therapy are applied to kill the cancer cells. After treatment, the bone marrow is replaced via a vein. Bone marrow from a healthy donor is also sometimes used.
  • Peripheral blood stem cell transplantation—Stem cells are removed from the blood before chemotherapy or radiation treatment. After treatment is done, the stem cells are then placed back into the blood.

Biological Therapy

These medicines increase or restore the body’s natural defenses against cancer. Sometimes a drug or antibody that is directed at the lymphoma is linked to a radioactive substance. It will deliver a focused dose of radiation to the tumor.

Prevention

There is no known way to prevent this form of cancer.

RESOURCES:

American Cancer Society
http://www.cancer.org

Leukemia and Lymphoma Society
http://www.leukemia-lymphoma.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Lymphoma Foundation Canada
http://www.lymphoma.ca

REFERENCES:

Bowzyk Al-Naeeb A, Ajithkumar T, et al. Non-Hodgkin Lymphoma. BMJ. 2018 Aug 22;362:k3204.

Non-Hodgkin lymphoma in children. American Cancer Society website. Available at: http://www.cancer.org/Cancer/Non-HodgkinLymphomainChildren/DetailedGuide/non-hodgkin-lymphoma-in-children-non-hodgkin-lymphomain-children. Accessed September 21, 2020.

Non-Hodgkin’s lymphoma (NHL). Children’s Hospital of Wisconsin website. Available at: https://www.chw.org/medical-care/macc-fund-center/conditions/oncology/non-hodgkins-lymphoma-nhl. Accessed September 21, 2020.

Non-Hodgkin lymphoma (HL). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/non-hodgkin-lymphoma-nhl. Accessed September 21, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 9/21/2020