• Hodgkin's Lymphoma—Child

    (Hodgkin's Disease—Child)

    Definition

    Hodgkin's lymphoma is a cancer of the lymphatic system. This system drains excess fluid from the blood. It also protects against infection. Hodgkin's lymphoma is different from other forms of lymphoma.
    Cancer occurs when cells in the body divide without control or order. In this case, the cells are a type of white blood cell called lymphocytes. If cells keep dividing uncontrollably, a mass of tissue forms. This is called a tumor. The term cancer refers to malignant tumors. These tumors invade nearby tissue and can spread to other parts of the body. A benign tumor does not invade or spread.
    The Lymphatic System
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    The exact cause is not known. It may be due to genetic and environmental factors that lead to changes in the immune system.

    Risk Factors

    Risk factors include:
    • Sex: male
    • Ages: 15-40 and over 55 (Hodgkin’s lymphoma is rare in younger children.)
    • Family history of Hodgkin’s lymphoma
    • History of Epstein-Barr virus (the virus that causes mononucleosis )
    • Weakened immune system (eg, HIV/AIDS )
    • Exposure to certain chemicals (eg, formaldehyde)
    • Use of human growth hormone for an extended amount of time

    Symptoms

    Symptoms include:
    • Painless swelling of the lymph nodes in the neck, armpit, groin, or chest
    • Fatigue
    • Night sweating
    • Coughing
    • Unexplained fever
    • Weight loss
    • Itching
    • Decreased appetite
    • Frequent infections (eg, cold , flu , sinus infection )
    Tell the doctor if your child has any of these symptoms.

    Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will also be done. The doctor will examine your child’s lymph nodes. Most swollen lymph nodes result from infection, not cancer.
    If swelling persists, the doctor may order:
    • Blood tests—to evaluate the condition of the liver and blood
    • Lymph node biopsy —to check for cancer
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body; done to evaluate the lymph nodes
    • PET scan —a test that uses a small amount of radiation to show activity in the body tissue
    • Bone marrow biopsy —a needle is inserted into a bone to sample the marrow which makes blood cells
    • Lymphangiogram—dye is injected into the lymph system to see which areas are involved

    Treatment

    Treatment depends on the stage of the disease:
    • How far the cancer has spread
    • Affected organs
    Work with the doctor and the healthcare team to determine the best treatment plan for your child. Treatment options include:

    Chemotherapy and Radiation Therapy

    Chemotherapy is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells. With radiation therapy , radiation is directed at the tumor to kill the cancer cells. In many cases, both chemotherapy and radiation are used.

    Surgery

    In some cases, the doctor may surgically remove a tumor. Also, the spleen may need to be removed.

    Transplantation

    Two types of transplants may be used:
    • Bone marrow transplantation —Bone marrow is removed, treated, and frozen. Large doses of chemotherapy and/or radiation therapy are applied to kill the cancer cells. After treatment, the bone marrow is replaced via a vein. Transplanted bone marrow may be your child’s bone marrow that was treated to remove cancer cells or marrow from a healthy donor.
    • Peripheral blood stem cell transplantation—Stem cells are removed from circulating blood before chemotherapy or radiation treatment and then replaced after treatment.

    Prevention

    Since the exact cause is unknown, there is no way to prevent this type of cancer.

    RESOURCES

    American Cancer Society http://www.cancer.org/

    Leukemia and Lymphoma Society http://www.leukemia-lymphoma.org/

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca/

    Lymphoma Foundation Canada http://www.lymphoma.ca/

    References

    Badash M. Hodgkin’s lymphoma. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 2009. Accessed July 6, 2010.

    Children’s Hospital of Wisconsin. Hodgkin’s lymphoma in children. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/21998/router.asp . Accessed July 6, 2010.

    Children’s Hospital Boston. Hodgkin’s lymphoma. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1043/mainpageS1043P0.html . Accessed July 6, 2010.

    DynaMed Editorial Team. Hodgkin disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 28, 2010. Accessed Accessed July 6, 2010.

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