• Hodgkin's Lymphoma Overview

    Hodgkin's lymphoma is a type of cancer that causes cells in the lymphatic system to abnormally reproduce, eventually making the body less able to fight infection. It is the most common cancer in people ages 15 to 19, and also one of the most treatable.

    Distinguished from other types of lymphoma by the presence of Reed-Sternberg cells, Hodgkin lymphoma usually begins in the lymph nodes of one part of a child’s body, usually the head, neck or chest, and then tends to spread in a predictable manner from one part of the lymphatic system to the next. In advanced stages, the disease can spread to the lungs, liver, bones, bone marrow or other organs. 

    There are two types of Hodgkin's lymphoma:

    • Classical Hodgkin lymphoma, the more common type of disease, characterized by the presence of large, abnormal Reed-Sternberg cells
    • Nodular lymphocyte predominant, a rare type involving variants of Reed-Sternberg cells called “popcorn” cells because of their appearance 

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

    Children and young adults with Hodgkin's lymphoma are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through our Lymphoma Program. Continue reading to learn more about 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 Hodgkin's lymphoma include:

    • Painless swelling of lymph nodes in the neck, underarm, groin or chest
    • Dyspnea – difficulty breathing due to enlarged lymph nodes in the chest
    • Fever
    • Night sweats
    • Fatigue
    • Weight loss
    • Pruritus (itching skin)
    • Frequent viral infections (cold, flu, sinus infections)

    In addition to a complete physical examination, doctors diagnose Hodgkin's lymphoma with:

    • Complete blood count
    • Sedimentation rate – drawn blood is checked to see how quickly it settles to the bottom of a test tube
    • Chest X-ray
    • Computerized tomography (CT or CAT) scan
    • Positron emission tomography (PET) scan
    • Bone marrow biopsy and aspiration
    • Lymphangiogram – dye is injected into the lymphatic system to determine the extent of involvement in areas otherwise difficult to visualize

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

    Treatment & Care Options

    Treatment of Hodgkin's lymphoma may include the following, alone or in combination:

    • Chemotherapy 
    • Radiation therapy 
    • Surgery – may be used to treated lymphocytic predominant disease that involves only one lymph node, but is not used to treat classical Hodgkin lymphoma
    • Stem cell transplant – often used when the lymphoma progresses despite initial treatment or when it relapses

    Progressive or Recurrent Disease

    Treatment of recurrent Hodgkin's lymphoma depends on where the disease recurs, previous treatments and the time since the first treatment was completed. These treatments include:

    Long-term Outlook

    Both classical and nodular lymphocyte predominant Hodgkin's lymphoma are highly curable, with survival rates above 90 percent. Children and adolescents may have treatment-related side effects that can appear months or years after treatment, including problems with bone growth and development of sex organs in males, infertility, and thyroid, heart and lung diseases. As many as 30 percent of patients who survive childhood Hodgkin lymphoma develop a secondary cancer after diagnosis, primarily breast cancer, non-Hodgkin lymphoma, thyroid cancer or acute leukemia.
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    Dana-Farber/Boston Children's has one of the largest and most experienced pediatric stem cell transplant programs in the United States. Watch Dr. Leslie Lehmann explain how stem cell transplants work.