• 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.

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