About Non-Hodgkin Lymphoma in Children
The causes of NHL in children are not fully understood. However, genetic mutations and changes in the DNA of lymphocytes are believed to play a role.
Non-modifiable risk factors (factors a person cannot change or control) of NHL in children include:
- Age: NHL is more common in older children (> 5 years old) and teenagers.
- Sex assigned at birth: Males are slightly more likely to develop NHL than females.
- Race: Children who are white are more frequently diagnosed with NHL than children who are Black.
- Family history: Having a sibling or parent with NHL may possibly increase the risk.
- Immune system disorders: Children with weakened immune systems, either due to genetic conditions or immunosuppressive medications for conditions like organ transplant, have a higher risk.
- Certain genetic conditions: Down syndrome and ataxia-telangiectasia increase the risk of developing NHL in children.
Modifiable risk factors (factors a person potentially can change or control) of NHL in children:
- Exposure to certain infections: Infections with certain viruses, such as Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV), may increase the risk.
- Radiation exposure, such as from X-rays or computed tomography (CT) scans, may possibly increase risk.
- Environmental factors: Exposure to pesticides and certain chemicals may increase the risk, although more research is needed in this area.
It's important to note that these risk factors do not guarantee the development of NHL in children. Regular check-ups and early detection can improve outcomes. If you have concerns about your child's health, consult a healthcare professional for personalized advice.
Symptoms of non-Hodgkin lymphoma (NHL) in children include:
- Swollen lymph nodes, usually starting in the neck, chest, underarms, or groin
- Cough and shortness of breath if the swollen nodes are in the neck and chest
- Fevers
- Rashes
- Decreased appetite
- Paler skin (this symptom may not be apparent depending on the child's skin tone)
- Night sweats
- Unexplained fevers
- Stomach pain if NHL begins in the abdomen
- Change in bowel movements if NHL starts in the abdomen
- Swelling in the belly
It's important to note that symptoms can vary depending on where the cancer first develops. If your child experiences any of these symptoms, it is recommended to speak with a healthcare professional for further evaluation.
To diagnose NHL in children, doctors commonly perform the following examinations, tests, and procedures:
- History and physical examination: The doctor will ask about the child's medical history and perform a physical exam to assess symptoms and identify any abnormalities.
- Blood tests: This involves checking a blood sample for substances released by organs and tissues in the body. Abnormal levels may indicate disease.
- Liver function tests: A blood sample is checked to measure substances released by the liver. Elevated levels may indicate cancer.
- Computed tomography (CT): Detailed pictures of the body are taken from different angles to identify areas of concern, such as the neck, chest, abdomen, and pelvis.
- Biopsy (tissue samples): A biopsy may be performed to collect tissue samples to be examined under a microscope to look for cancer cells. Biopsies may collect tissue from a lymph node, tumor, or bone marrow.
Additional examinations, tests, and procedures may be performed based upon initial findings or individual factors, or to gather information needed to determine the stage of NHL. These may include:
- Additional imaging studies, such as ultrasound, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan may be used to assess the extent of disease throughout the body.
- MRI with gadolinium: This procedure uses a magnet, radio waves, and a computer to create detailed pictures of areas inside the body. Gadolinium is injected into a vein to highlight cancer cells.
- Lumbar puncture: Cerebrospinal fluid is collected from the spinal column using a needle. It is then examined under a microscope to check for cancer spread to the brain and spinal cord.
The stages of NHL are based upon the location and spread of NHL. The stages are:
- Stage 1: NHL is found in one area (a single tumor) or in lymph nodes in only one part of the body (such as the underarm or groin).
- Stage 2: NHL is found in one area (a single tumor) and a nearby lymph node, two or more lymph nodes either above or below the diaphragm, or in the digestive tract and limited enough to be removed by surgery. All cancer is found on one side of the diaphragm.
- Stage 3: NHL is found in more than one area (more than a single tumor), in lymph nodes on both sides of the diaphragm, in the chest, in the abdomen and too much spread to be removed by surgery, next to the spine, or in a bone.
- Stage 4: NHL is found in the bone marrow, spinal cord, or brain.
Remember, these are general descriptions. Your child's doctor will determine which examinations, tests, and procedures are necessary based on their specific situation.
The goals of treatment for non-Hodgkin lymphoma (NHL) in children are to:
- Eliminate or control the cancer
- Prevent the spread of cancer to other parts of the body
- Relieve symptoms and improve quality of life
The treatment options for NHL in children include:
- Chemotherapy: Medications that kill cancer cells or prevent their growth.
- Surgery: In some cases, surgery may be performed to remove tumors. In many cases, surgery is followed by chemotherapy.
- Radiation therapy: High-energy rays used to kill cancer cells or shrink tumors.
- Immunotherapy: Boosts the body's immune system to fight cancer cells.
- Targeted therapy: Drugs that specifically target cancer cells without harming normal cells.
- Retinoid therapy: Medications derived from vitamin A that help regulate cell growth.
- Stem cell transplant: Replacement of damaged bone marrow with healthy stem cells.
It is important to note that specific treatment plans should be determined by a team of doctors who specialize in treating childhood cancer. Medication dosing may be affected by many factors, so it is best to consult with a healthcare professional for personalized advice. Other side effects can occur, so it is important to discuss potential risks and benefits with your healthcare professional or refer to medication information for more details.