Hodgkin Lymphoma

Childhood Hodgkin lymphoma is a type of cancer that develops in the lymph system, part of the body's immune system. Because lymph tissue is found throughout the body, Hodgkin lymphoma can start in almost any part of the body and spread to almost any tissue or organ in the body.

There are two types of childhood Hodgkin lymphoma:

  • Classical Hodgkin lymphoma.
  • Nodular lymphocyte-predominant Hodgkin lymphoma.

Classical Hodgkin lymphoma is divided into four subtypes, based on how the cancer cells look under a microscope:

  • Lymphocyte-rich classical Hodgkin'lymphoma.
  • Nodular sclerosis Hodgkin lymphoma.
  • Mixed cellularity Hodgkin lymphoma.
  • Lymphocyte-depleted Hodgkin'lymphoma

 

Stages of childhood Hodgkin lymphoma may include A, B, E, and S.

 

Childhood Hodgkin lymphoma may be described as follows:

  • A: The patient has no symptoms.
  • B: The patient has symptoms such as fever, weight loss, or night sweats.
  • E: Cancer is found in an organ or tissue that is not part of the lymph system but which may be next to an involved area of the lymph system.
  • S: Cancer is found in the spleen.

The following stages are used for childhood Hodgkin lymphoma:

Stage I: Stage I is divided into stage I and stage IE.

  • Stage I: Cancer is found in one or more lymph nodes in one lymph node group.
  • Stage IE: Cancer is found outside the lymph nodes in one organ or area.

Stage II: Stage II is divided into stage II and stage IIE.

Stage II: Cancer is found in two or more lymph node groups above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).

  • Stage IIE: Cancer is found in one or more lymph node groups above or below the diaphragm and outside the lymph nodes in a nearby organ or area.

Stage III: Stage III is divided into stage III, stage IIIE, stage IIIS, and stage IIIE+S.

  • Stage III: Cancer is found in one or more lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).

  • Stage IIIE: Cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area.

  • Stage IIIS: Cancer is found in lymph node groups above and below the diaphragm, and in the spleen.

  • Stage IIIE+S: Cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area, and in the spleen.

Stage IV: In stage IV, the cancer:

  • is found outside the lymph nodes throughout one or more organs, and may be in lymph nodes near those organs; or
  • is found outside the lymph nodes in one organ and has spread to lymph nodes far away from that organ; or
  • is found in the lung, liver, or bone marrow.

 

Treatment of Hodgkin Lymphoma

Different types of treatment are available for children with Hodgkin lymphoma. Some treatments are standard and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Three types of standard treatment are used:

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. One type of targeted therapy being used in the treatment of childhood Hodgkin lymphoma is monoclonal antibody therapy.

Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

 

New types of treatment are being tested in clinical trials.

High-dose chemotherapy with stem cell transplant

High-dose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Surgery

Surgery may be done to remove as much of the tumor as possible.

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/pdq/treatment/childhodgkins/Patient/page1. (Accessed July 2016)