• Non-Hodgkin's Lymphoma Overview

    Non-Hodgkin's lymphoma, a cancer of the lymph system, which helps to fight disease and infection, is not one disease, but a group of diseases that share similarities in how they look under a microscope and that they all start in lymph tissue. The third most common childhood cancer, non-Hodgkin's lymphoma causes a child’s lymphatic system to abnormally produce immune cells called lymphocytes, eventually causing tumors to grow. These tumors can spread throughout the body, including to other lymph nodes, the liver, spleen, bone marrow, spinal fluid, and lung.

    There are several types of non-Hodgkin's lymphoma, including:

    Non-Hodgkin's Lymphoma Treatment at Dana-Farber/Boston Children's

    Patients with non-Hodgkin's lymphoma are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Lymphoma Program. Continue reading to learn more about non-Hodgkin's lymphoma or visit the Lymphoma Program homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    The symptoms of non-Hodgkin's lymphoma vary, depending on where the lymphoma starts. Some children with non-Hodgkin's lymphoma have symptoms of an abdominal mass and complain of fever, constipation and decreased appetite; others complain of respiratory problems, including dyspnea (pain with deep breathing), cough and wheezing.

    Common symptoms of non-Hodgkin's lymphoma include:

    • Painless swelling of the lymph nodes in the neck, chest, abdomen, underarm or groin
    • Fever without any other obvious explanation
    • Abdominal symptoms such as swelling or cramping
    • Night sweats
    • Tiring easily
    • Non-intentional weight loss
    • Respiratory symptoms, including shortness of breath, trouble breathing, wheezing, or high-pitched breathing sounds
    • Swelling of the head and neck

    An accurate diagnosis is critical, as some forms of non-Hodgkin's lymphoma can crow very quickly (other forms are more slow growing). Tests to make a diagnosis and determine disease stage include:

    • Physical exam to check for lumps from swollen lymph nodes
    • Patient history, including current symptoms, eating habits, lifestyle habits, and past illnesses and treatments
    • Computerized tomography (CT or CAT) and magnetic resonance imaging (MRI) scans from the neck to pelvis
    • Positron emission tomography (PET) scan
    • Chest X-ray
    • Biopsy, including excisional (complete), incisional (partial), core (wide needle) and fine-needle biopsy
    • Bone marrow aspiration (removal) and biopsy to look for lymph cells
    • Lumbar puncture (spinal tap)
    • Complete blood count

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    The major factor in treating non-Hodgkin's lymphoma is whether the cancer is isolated (localized) to a specific part of the body or if it has spread. Limited chemotherapy is given for localized disease, while multiple chemotherapy drugs or chemotherapy injected into the spinal cord are used to treat non-Hodgkin's lymphoma that has spread. Radiation therapy is rarely used for treat non-Hodgkin's lymphoma. Newer techniques such as monoclonal antibody therapy and stem cell transplant may also be used.

    Progressive or Recurrent Disease

    Children with progressive or recurrent disease are often treated with combination therapy or high-dose chemotherapy with stem cell transplantation.

    Long-term Outlook

    The long-term outlook for children with non-Hodgkin's lymphoma is excellent. More than 80 percent of children are cured and can resume a normal life, returning to school, social activities and athletics usually within a year after treatment has finished.
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