Lymphoma in Children and Young Adults

Reviewed by: HU Medical Review Board | Last reviewed: June 2020.

Lymphoma is one of the most common cancers in children. Other common cancers in children include leukemia, and brain and central nervous system cancers. Lymphoma also occurs in adults, but cancers in children are often different than cancers in adults. While cancers like lymphoma tend to be more aggressive in children than adults, these types of cancer generally respond well to treatment. Children are also typically able to better handle stronger, more intense courses of chemotherapy, and more children are surviving cancers like lymphoma now than ever before.1,2

About lymphoma

Lymphoma is a cancer that is found in the lymphatic system, which is comprised of the lymph nodes, lymphatic vessels, and several organs. Lymphomas develop from lymphocytes, which are white blood cells that play an important role in the immune system.

There are 2 major types of lymphoma: Hodgkin lymphoma (also called Hodgkin disease) and non-Hodgkin lymphoma. Both Hodgkin and non-Hodgkin lymphoma generally develop from either the T cell or B cell lymphocytes, although B cell lymphomas are much more common.2,3

Hodgkin lymphoma is most common in 2 age groups: young adults in their 20s, and older adults after age 55. The childhood form of Hodgkin lymphoma is relatively rare in children. Most cases of Hodgkin lymphoma are classic Hodgkin lymphoma (cHL), which is defined by a specific type of cell called Reed-Sternberg cells.2

Non-Hodgkin lymphoma (NHL) accounts for approximately 5 percent of all childhood cancers. NHL is more common in boys than girls, and more common in white children than black children. There are more than 60 subtypes of NHL and children most often have an aggressive form of the disease. Most children with NHL have:2,4

  • Lymphoblastic lymphoma
  • Burkitt lymphoma
  • Large cell lymphoma

What causes lymphoma in children?

Most cases of lymphoma do not seem to occur from inherited mutations (those passed from parent to child). Researchers believe that lymphomas may occur due to changes in the DNA or a reaction to infection. Lymphomas often occur for no reason.2

What factors increase a child's risk of developing lymphoma?

Some children with lymphoma have no known risk factors, or they may only have 1 or 2. Risk factors that have been identified as potentially increasing an individual's chances of developing lymphoma include:2-4

  • Having an immune deficiency, which may be due to an inherited condition (like ataxia-telangiectasia, Bloom syndrome, severe combined immunodeficiency syndrome, or Wiskott-Aldrich syndrome), or due to medications like those for organ transplant recipients
  • Having an autoimmune disease such as lupus or rheumatoid arthritis
  • Having certain chronic infections, such as human immunodeficiency virus (HIV), Epstein-Barr virus (mononucleosis), hepatitis C, or the bacterium Helicobacter Pylori (H Pylori)

What are common symptoms of lymphoma in children?

Many of the general symptoms of blood cancers can also be caused by other conditions, so it is important to see a doctor to find out what is causing these symptoms. In addition, not every child with lymphoma has the same symptoms. General symptoms that may be caused lymphoma include:2,4,5

The feeling of fullness in the abdomen may be due to the liver or spleen becoming swollen and putting pressure on the stomach. If this occurs, a child may not be hungry or may stop eating after only a small amount of food.2,5

Enlarged lymph nodes that occur in the chest can cause coughing, or a child may complain that breathing is more difficult.2,5

How is lymphoma staged in children?

Lymphomas may be classified in children and young adults as Stage I, II, III, or IV. These stages may be further subdivided to indicate if cancer has been found in lymph nodes throughout the body. The staging may also include the letters A, B, E, S, or X.2,4

  • A means the child has no symptoms.
  • B means the child has symptoms like fever or weight loss.
  • E means cancer found outside of the lymph system.
  • S means cancer found in the spleen.
  • X means "bulky disease" or that the cancer cells are larger than 10 cm.

What is the prognosis of childhood lymphoma?

Many advances have been made in treating lymphoma in children, and the survival rates have increased over the past several decades. Prognosis is dependent on many things, especially the particular subtype of lymphoma and how it responds to treatment.2

Survival rates are based on past data of people who survive a set amount of time after diagnosis. In cancer estimates, experts use the "5-year survival rate" as a marker. However, it is important to keep in mind that many people live beyond 5 years after diagnosis and the statistics do not necessarily predict any single person's survival.5

The 5-year survival rate for Hodgkin lymphoma in children is 98 percent, and 97 percent for teens. The 5-year survival rate for non-Hodgkin lymphoma in children younger than 15 is 91 percent and the survival rate for teens ages 15 to 19 is 88 percent.5

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