Lymphomas - Lymphomas

Lymphomas
last updated 7/05
Ped Onc Resource Center

On this site: Warning Signs of Childhood Cancer: Lymphomas

Lymphomas are malignant cell infiltrations of the lymphatic system. The lymph system includes the nodes with which of us are familiar, located in the neck, armpit, and groin. These nodes are only part of the lymph system, as they are connected to each other and to the spleen, thymus, and parts of the tonsils, stomach, and small intestine by a network of vessels. The vessels carry a colorless, watery fluid called lymph, and contains lymphocytes. Once a malignancy begins in one part of the lymph system, it often spreads throughout the rest of the system before it is detected. Lymphomas share similar symptoms such as painless swelling of the lymph nodes, fever and fatigue.

Lymphomas, close cousins to the leukemias, are divided into many sub-groups according to cell types. Broadly, they are classified as either non-Hodgkin's and Hodgkin's. Of these two types, non-Hodgkin's (NHL) is the more common in children. About 15 types of NHL have been identified, although three of these types are the main ones which occur in children (see below). NHL in children occurs more frequently between the ages of ten and twenty than under ten. Hodgkins cases in children are rare under five years of age; in children under age 10, it is more common in boys than girls. Currently, Hodgkin's lymphoma is more curable than non-Hodgkin's.

General Disclaimer

These pages are intended for informational purposes only and are not intended to render medical advice. The information provided on Ped Onc Resource Center should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you suspect your child has a health problem, you should consult your health care provider.

NHL (Non-Hodgkin's Lymphoma)
Recommended cancer.gov link: NCI PDQ

The three types of NHL that occur most often in children are:

lymphoblastic: Predominantly T-cell origin, sometimes hard to distinguish from leukemia; 30% of childhood NHLs.
small noncleaved cell lymphoma (Burkitt's and non-Burkitt's): B-cell origin, cALLa; 40-50% of childhood NHLs.
large cell lymphoma A heterogeneous group B lineage and T lineage, some are like both T and B; 20-25% of childhood NHLs.
Descriptions of NHL are given at other web sites, especially:

Mike's Lymphoma Resource Pages.
Cancer.gov site
The author of "Mike's" pages has done excellent jobs in describing lymphomas, including details on cell classification, diagnosis, the lymph system, and statistics. Both pages focus largely on adult rather than childhood concerns, but the descriptions do cover the full age range of the disease.

Statistics for NHL

6% of childhood cancers,
1.0-1.5 per 100,000 children will be diagnosed with NHL
more common in ages 10-20
very unusual in children less than 3
frequent malignancy in children with AIDS
60% with NHL will be cured
Hodgkin's Lymphoma
Recommended cancer.gov link: NCI PDQ

Hodgkin's lymphoma is characterized by the presence of large, binucleated cells called "Reed-Sternberg cells." The normal counterpart of these cells is not known - they are of either a B or a T lineage. Hodgkin's disease usually presents with enlarged lymph nodes. Hodgkin's has a cure rate of 75%.

Descriptions of Hodgkin's are given at other web sites, especially:

Mike's Lymphoma Resource Pages.
Cancer.gov site
Treatment for Lymphomas
The treatment for all types of lymphoma depends on type, stage, and grade of disease. The types are listed in the descriptions and the embedded links. The stages and grades are outlined below.

Stages:
I cancer site, no bone marrow involvement
II two sites, both either above or below the diaphragm; no bone marrow involvement
III sites above and below the diaphragm; no bone marrow involvement
IV bone marrow is effected or the cancer cells have spread outside the lymphatic system
B fever, weight loss or night sweats
A absence of fever, weight loss or night sweats
E disease has spread to organs outside the lymph system
Grades:
high: usually found in B-cell and T-cell types
intermediate: usually found in B-cell and T-cell types
low: predominantly found in B-cell types
Lymphomas are usually treated by a combination of chemotherapy, radiation, surgery, and/or bone marrow transplants. The cure rate varies greatly depending on the type of lymphoma and the progression of the disease.

Clinical trial information:
NCI clinical trial search form. This link takes you to a form to fill out and submit for the particular type of cancer you are researching.

Ped-Onc Resources for Lymphomas
The following ped-onc resource lists have appropriate sections for parents of children with brain tumors:

childhood cancer e-mail lists - the ACOR ped-lymphoma list and the general childhood cancer list, ped-onc, are both appropriate
support organizations - Leukemia and Lymphoma
books and printed materials - leukemias and lymphomas
young people with lymphoma - personal home pages
Links to More Information
The following web sites provide good, general information on lymphomas cancers and their treatment.

Mike's Lymphoma Resource Pages - a comprehensive lymphoma site with good coverage of pediatric lymphomas.
Cancer.gov site on NHL and lymphomas.
Lymphoma Research Foundation (LRF). This a very comprehensive site. Although it focuses on adult lymphomas, the disease descriptions, staging, grades, support, and treatment sections offer invaluable information to parents of children with lymphomas. This site also keeps tabs on new treatments.
Cure Hodgkins Disease and treatment information, support, survivors' stories.
NHL cyber family Web Site. Worth a look, good link, personal stories.
Univ. of Washington hematopathology lab web site: lab tests and profiles for lymphoma cell types.