Treating Lymphoma in Children

Lymphoma is one of the most common cancers in children. Lymphoma that occurs 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

There are two major types of lymphoma: Hodgkin lymphoma (also called Hodgkin disease) and non-Hodgkin lymphoma. Hodgkin lymphoma accounts for about 3% of all childhood cancers, although it is more common among young adults (usually in their 20’s) and older adults (after age 55). Non-Hodgkin lymphoma (NHL) accounts for about 5% of all childhood cancers.3

Types of treatment for childhood lymphoma

There are several different types of treatment that may be used to treat lymphoma in children, including:

  • Chemotherapy
  • Stem cell transplant
  • Targeted therapy
  • Radiation therapy
  • Surgery
  • Phototherapy4,5

Chemotherapy

Chemotherapy is the use of drugs to stop cancer cells. Chemotherapy medications may be used in combination, and chemotherapy works by targeting fast-growing cells, such as cancer cells. However, there are other fast-growing cells in the body that can also be affected, such as those in the gastrointestinal tract and hair.4,5

The way chemotherapy medications are delivered depends on the type of lymphoma and how it is affecting the body. Some medications are given by mouth or injected into a vein or muscle. When lymphoma is affecting the brain or spinal cord, chemotherapy may be injected into the space around the spinal cord and brain (called intrathecal chemotherapy, as shown below). Chemotherapy can also potentially be injected into an organ or into the abdomen.4,5

Cerebrolspinal Fluid Chemotherapy

Stem cell transplants

Stem cell transplants are used in combination with high doses of chemotherapy. The high dose of chemotherapy destroys the cancer cells and also damages healthy blood cells. The transplant of stem cells, immature cells that can become new blood cells, is given to restore the bone marrow. The stem cells may be gathered from the patient prior to chemotherapy (called an autologous transplant), or they may be given by a donor (called an allogeneic transplant). Autologous stem cell transplants are generally more common in childhood lymphoma treatment. If an allogeneic stem cell transplant is performed, the donor’s tissue type should match the tissue type of the patient to the closest extent possible, and siblings or close relatives are often donors. However, the donor does not necessarily have to be related to the patient.4,5

Targeted therapy

Targeted therapies are cancer treatments that block or slow the spread of cancer by interfering with specific areas of cancerous cells that are involved in the cancer cell’s growth, or by focusing on particular characteristics that are unique to cancer cells. While chemotherapy drugs are cytotoxic, meaning they kill cancer cells, targeted therapy is typically cytostatic, meaning it blocks the growth of cancer cells. The types of targeted therapy that may be used to treat childhood lymphomas include:

  • Tyrosine kinase inhibitors (TKIs), which target a specific protein that is found on certain cancer cells
  • Monoclonal antibodies, which identify and block cancer growth or kill cancer cells
  • Proteasome inhibitors, which break down proteins inside cancer cells
  • Immunotoxins, which bind to cancer cells and cause them to die4,5

Radiation therapy

Radiation therapy uses high-energy radiation, and it may be used in certain cases of childhood lymphoma. Radiation may also be used in preparation for a stem cell transplant.4,5

Surgery

Surgery may be used in certain cases of lymphoma to remove tumors.5

Phototherapy

Phototherapy uses a drug and a type of laser light to kill cancer cells. The drug is injected into a vein and becomes active when the laser light is shined on the skin. Phototherapy may be used to treat certain patients with a type of NHL called cutaneous T-cell lymphoma.4

Clinical trials

Clinical trials are a type of research where new treatments are studied. Clinical trials are an important part of the scientific process to find and prove the safety and effectiveness of new treatments, and they offer patients a chance to receive the latest treatments and be closely monitored by healthcare professionals. Clinical trials can be found by talking to a doctor or through the website ClinicalTrials.gov. Patients can discuss treatment options with their doctor to determine if they might be eligible to participate in a clinical trial.2,6

Written by: Emily Downward | Last reviewed: March 2018
View References
  1. Children with cancer: a guide for parents, National Cancer Institute. Available at https://www.cancer.gov/publications/patient-education/children-with-cancer.pdf. Accessed 2/5/18.
  2. Survival rates for childhood Non-Hodgkin lymphoma, American Cancer Society. Available at https://www.cancer.org/cancer/childhood-non-hodgkin-lymphoma/detection-diagnosis-staging/survival-rates.html. Accessed 2/5/18.
  3. Cancers that develop in children, American Cancer Society. Available at https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html. Accessed 2/5/18.
  4. Childhood Non-Hodgkin lymphoma treatment (PDQ), National Cancer Institute. Available at https://www.cancer.gov/types/lymphoma/patient/child-nhl-treatment-pdq#section/_48. Accessed 2/5/18.
  5. Childhood Hodgkin lymphoma treatment (PDQ), National Cancer Institute. Available at https://www.cancer.gov/types/lymphoma/patient/child-hodgkin-treatment-pdq#section/_51. Accessed 2/5/18.
  6. ClinicalTrials.gov, National Institutes of Health. Available at http://www.clinicaltrials.gov. Accessed 2/5/18.