Rare Non-Hodgkin Lymphomas in Children
Most non-Hodgkin lymphomas (NHL) in children are fast
growing, aggressive cancers. The most common non-Hodgkin lymphoma diagnoses in children are Burkitt lymphoma, diffuse large B-cell lymphoma, lymphoblastic lymphoma
and anaplastic large cell lymphoma. However, there are several slow growing B-cell lymphomas that occur in this young age group. There are
also rare T-cell lymphomas that are more
frequently seen in adults but occasionally occur in children.
Types of Rare Non-Hodgkin Lymphoma in Children
Two types of indolent mature B-cell lymphomas that are
unique to younger patients are:
- Pediatric follicular lymphoma often presents as a localized
enlarged lymph node, stage I or II. (Learn more about non-Hodgkin lymphoma staging.) If this type of lymphoma is
completely removed by surgery, no additional treatment may be unnecessary.
Generally, the cure rate is excellent.
- Marginal zone lymphomas (MZL) can occur in lymph nodes or in
sites such as the gastrointestinal tract or the inner eyelids, where these
tumors are referred to as mucosa-associated lymphoid tissue (MALT)
lymphomas. These are slow growing, indolent tumors that may be treated
with surgery, radiation, the immunotherapy drug rituximab, or occasionally
with antibiotics.
Rare mature T-cell lymphomas include:
- Cutaneous T-cell lymphomas are indolent lymphomas that involve
only the skin. These diseases include mycosis fungoides and subcutaneous
panniculitis-like T-cell lymphoma. There is no standard therapy for these
lymphomas in children. Treatment may include steroids, retinoids,
chemotherapy, or radiation therapy.
- Peripheral T-cell lymphomas are a collection of aggressive
cancers of mature T-lymphocytes. Treatment includes chemotherapy and often
stem cell transplantation, either from the patient’s own bone marrow
(autologous) or sometimes from another person’s bone marrow (allogeneic). The
Dana-Farber/Boston Children’s Stem Cell Transplant Center offers
autologous and allogeneic stem cell transplants and is active in researching
new stem cell techniques.
Other rare non-Hodgkin lymphomas include:
- Primary central nervous system lymphoma (PCNSL) is defined by
its location in the brain or spinal cord and no place else in the body. Primary
central nervous system lymphoma in children is usually of the diffuse
large B-cell lymphoma type. PCNSL is more common in adults than in
children, but is rare in both age groups. In adults, PCNSL often occurs in
patients with a weakened immune system. Treatment for primary central
nervous system lymphoma requires high doses of chemotherapy that enter the
central nervous system (CNS), such as high-dose methotrexate and high-dose
cytarabine. Radiation therapy has been used as part of the treatment for
this lymphoma in adults, but may not be necessary if high dose
chemotherapy is used in the treatment plan.
- Cutaneous lymphomas are lymphomas that are only present in the
skin.
Rare Non-Hodgkin
Lymphoma Treatment at Dana-Farber/Boston Children's
Children with rare non-Hodgkin lymphomas are treated at
Dana-Farber/Boston Children's through the Lymphoma
Program in our Hematologic Malignancies Center.
One of the top pediatric cancer centers worldwide, Dana-Farber/Boston
Children’s combines the expertise of a premier cancer center – Dana-Farber
Cancer Institute – and a world-class children’s hospital – Boston Children’s
Hospital – to provide internationally-renowned care for children with cancers
of the blood and immune system.