Lymphoma

Lymphoma Overview

Lymphoma is a type of cancer involving cells of the immune system, called lymphocytes. Just as cancer represents many different diseases, lymphoma represents many different cancers of lymphocytes - about 35 different subtypes. Lymphoma is a group of cancers that affect the cells that play a role in the immune system, and primarily represents cells involved in the lymphatic system of the body.
The lymphatic system is part of the immune system. It consists of a network of vessels that carry fluid called lymph, similar to the way that the networks of blood vessels carry blood throughout the body. Lymph contains white blood cells called lymphocytes. Lymphocytes attack a variety of infectious agents as well as many cells in the precancerous stages of development.
Lymph nodes are small collections of lymph tissue that occur throughout the body. The lymphatic system involves lymphatic channels that connect thousands of lymph nodes scattered throughout the body. Lymph flows through the lymph nodes, as well as through other lymphatic tissues including the spleen, the tonsils, the bone marrow, and the thymus gland.
These lymph nodes filter the lymph, which may carry bacteria, viruses, or other microbes. The lymph nodes, or glands as they may be called, filter the lymph, which may on various occasions carry different microbial organisms. At infection sites, large numbers of these microbial organisms collect in the regional nodes and produce the swelling and tenderness typical of a localized infection. These enlarged and occasionally confluent collections of lymph nodes (so-called lymphadenopathy) are often referred to as “swollen glands.”
Lymphocytes recognize pathogens (infections and abnormal cells) and destroy them. There are 2 major subtypes of lymphocytes:
- B lymphocytes (B Cells): B lymphocytes produce antibodies (proteins that circulate through the blood and lymph and attach to infectious organisms and abnormal cells). The combination attachment cell or antibody microbial organism essentially alerts other cells of the immune system recognize and destroy these intruders, also known as pathogens.
- T lymphocytes (T Cells): T cells, when activated, can kill pathogens directly. T cells also play a part in the mechanisms of immune system control, to prevent the system from inappropriate over activity or under activity.

Occurrences

Hodgkin’s lymphoma is a lot rarer than non-Hodgkin’s lymphoma, accounting for less than 1 percent of all cases in the United States. Hodgkin’s lymphoma accounts for about 5 percent of childhood cancers, occurring most often in people between the ages of 15 and 34, and in people over the age of 55. For some unknown reason males are twice as more likely to be infected with the disease than females.
Non-Hodgkin’s lymphoma is the third most common childhood cancer. It occurs most often in children between the ages of 7 and 11, and sometimes any age from infancy to adulthood. Non-Hodgkin’s affects males more than three times more often than females. It is most common amongst Caucasian children than children of other races.

What causes Lymphoma?

A specific cause is still unknown; however, it is possible that a genetic predisposition and exposure to viral infections may increase the risk of developing this kind of malignancy. There is an increased chance of Hodgkin’s lymphoma occurring in siblings and cousins of patients. There has been much investigation into the association of the Epstein-Barr virus (EBV), which causes the infection mononucleosis, as well as HIV and AIDS. Both these infectious viruses have been correlated with a greater incidence of children diagnosed with lymphoma. There are many individuals; however, who have infections related to EBV and HIV that do not develop lymphoma.
The development of non-Hodgkin’s lymphoma has been associated with chemotherapy and radiation therapy. Non-Hodgkin’s may as a result be a second malignancy as a result of the treatment for certain cancers. Children and adults with other hereditary abnormalities or who have undergone solid organ transplantation face an increased risk of developing lymphoma.

Symptoms

Below are the most common forms of symptoms; however, children may experience symptoms differently:
- Painless swelling of lymph nodes in neck, chest, abdomen, underarm or groin
- Sore throat
- Fever
- Fatigue
- Decreased appetite / weight loss
- Night sweats
- Itching skin
- Frequent viral infections (cold, flu, sinus infection)
- Difficulty breathing (due to enlarged nodes in chest- Hodgkin’s)
- Fullness in groin area from node involvement

Diagnosis

Children experiencing symptoms associated with lymphoma will need to have their complete medical history reviewed by a doctor, followed by a full physical exam. Other diagnostic procedures include blood tests, imaging tests, and a biopsy.

Treatment

Doctors will determine the best form of treatment based on:
- Child’s age, overall health and medical history
- The extent of the disease
- Your child’s tolerance for specific medications, procedures, or therapies
- The expectations for the course of the disease
- Your opinion or preference

Treatments for all lymphomas can involve any of the following:
- Chemotherapy
- Radiation therapy
- Surgery
- Close monitoring of blood work
- Stem cell transplant
- Bone marrow examinations
- Lumbar punctures/ spinal taps
- Antibiotics
- Supportive care
- Long-term follow up care

Prognosis greatly depends on:
- The extent of the disease
- The presence of absence of metastasis
- The response to therapy
- Age and overall health of the child
- New developments in treatment

As with any cancer, prognosis and long-term survival can vary greatly from child to child. Every child is unique and treatment and prognosis is structured around the child. Continuous follow-up care is essential for the child diagnosed with lymphoma. Side effects from treatment as well as second malignancies can occur in survivors of lymphoma.

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