Childhood Hodgkin Lymphoma

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KEY POINTS

• Hodgkin lymphoma is a growth of abnormal white blood cells that forms tumors in the lymph system. The lymph system is part of the body's system for fighting infection.
• Treatment may include radiation therapy, chemotherapy, stem cell transplant, or a combination of these and other therapies.
• Talk about your child’s cancer and treatment options with your child’s healthcare provider. Make sure you understand the treatment choices.

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What is childhood Hodgkin lymphoma?

Hodgkin lymphoma is a growth of abnormal cells that forms tumors in the lymph system. The lymph system is part of your child’s body's system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between the body and the bloodstream. This disease can occur in one lymph node, in a group of nodes, or in an organ. It can then spread to almost any part of your child's body.

Hodgkin lymphoma is one of the many types of lymphoma. Other types of lymphomas are called non-Hodgkin lymphomas. The type of lymphoma is determined by how the cancer cells look under a microscope.

Hodgkin lymphoma, sometimes called Hodgkin disease, is one of the most curable cancers. The sooner cancer is found and treated, the better the chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that your child has.

What is the cause?

The exact cause of Hodgkin lymphoma is unknown.

Hodgkin lymphoma is most common in teens, adults up to age 35, and adults age 55 and older.

There is a slightly higher risk for Hodgkin lymphoma if:

• Your child had infectious mononucleosis (mono), which is an infection caused by the Epstein-Barr virus.
• You have close relatives (parent, brother, or sister) with Hodgkin lymphoma.
• Your child has a weakened immune system.

What are the symptoms?

Symptoms may include:

• Painless swelling of lymph nodes, in the neck, armpits, or groin
• Fever and night sweats
• Weight loss for no known reason
• Itching
• Tiredness

How is it diagnosed?

Your child's healthcare provider will ask about symptoms and examine your child. Your child may have a lymph node biopsy, which uses a needle passed through the skin to take a small sample of tissue for testing. If Hodgkin lymphoma is found, more tests will be done to learn the stage or the extent of the disease. These tests may include:

• Blood tests
• Chest X-ray
• CT scan, which uses X-rays and a computer to show detailed pictures of the lymph nodes
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the lymph nodes
• PET scan, which is a series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive chemical into your child’s blood. The scan shows areas where the radioactive chemical is being absorbed.
• A bone marrow biopsy, which uses a needle passed through the skin to take a small sample of tissue for testing

How is it treated?

You and your healthcare provider will discuss possible treatments for your child. You may also talk with a cancer specialist. Some things to think about when making treatment decisions are:

• Your child's age
• Your child's overall health
• The stage of the cancer (how advanced the cancer is)
• Whether the cancer has spread to other parts of your child's body

Possible treatments are:

• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Biological therapy, which uses medicine designed to help your child’s immune system fight the cancer or block the growth of cancer cells
• Stem cell or bone marrow transplant, which uses your child's own cells or cells from a donor
• Supportive therapy, which includes antibiotic medicine and blood transfusions

Your child's treatment will also include:

• Preventing infections
• Controlling pain or other symptoms
• Preventing or controlling the side effects from treatments, which may be different for each person based on the treatment your child receives
• Helping your child and your family cope with cancer

Often, more than 1 type of treatment is used. Your child will need to have regular follow-up visits with his or her healthcare provider.

Ask your healthcare provider about clinical trials that might be available to your child. Clinical trials are research studies to find effective cancer treatments. It’s always your choice whether your child takes part in one or not.

How can I take care of my child?

If your child has been diagnosed with Hodgkin lymphoma:

• Talk about your child’s cancer and treatment options with your child’s healthcare provider. Make sure you understand the treatment choices.
• Follow the full course of treatment prescribed by your child’s provider.
• Ask your child’s provider:
  • How and when you will get your child’s test results
  • How long it will take your child to recover
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them
• Make sure you know when your child should come back for a checkup.

It may also help if your child:

• Eats a variety of healthy foods
• Gets regular physical activity as advised by your child’s healthcare provider
• Gets plenty of rest
• Takes time for activities that your child enjoys
• Tells you or your child’s provider if treatment causes discomfort. Usually there are ways to help your child be more comfortable.

Counseling and support groups can help children and parents cope with the situation and help the family adjust to the changes in their lives.

For more information, contact:

• American Childhood Cancer Organization
  855-858-2226
  https://www.acco.org/
• American Cancer Society
  800-227-2345
  https://www.cancer.org/
• National Cancer Institute
  800-422-6237
  https://www.cancer.gov/