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Hodgkin's Lymphoma

Hodgkin lymphoma is a type of lymph node cancer. Every year, approximately 30-40 children in the Netherlands are diagnosed with Hodgkin lymphoma. The disease occurs mainly in teenagers, and more often in girls than in boys. Hodgkin lymphoma involves uninhibited division and growth of lymphocytes, a particular type of white blood cells. These form a tumor in a lymph node that spreads easily to other lymph nodes, and sometimes to organs and tissues as well. Most children have classic Hodgkin lymphoma (90%); some have non-classic Hodgkin lymphoma.

The brochure entitled Hodgkin lymphoma contains comprehensive information about this disease. The most important information is provided below.

Causes

Little is known about what causes Hodgkin lymphoma. Usually something in the DNA of one of the cells in the lymph node is damaged, causing this cell to behave abnormally. Viral infections, such as the Epstein-Barr virus, and weakened immunity might have something to do with it.


Symptoms

Most children have swollen lymph nodes that feel hard but are not painful and do not cause any symptoms. Children with a tumor in the chest cavity might suffer from persistent coughing and shortness of breath. Other symptoms include night sweats, fever, lack of appetite, itching and fatigue. If the disease spreads to organs, symptoms can include anemia, fluid around the lungs or bone pain.

How is Hodgkin lymphoma diagnosed?

An enlarged lymph node is removed under anesthesia and then examined under the microscope. An ultrasound, lung X-rays and various scans are also performed.

Treatment

Classic Hodgkin lymphoma requires intensive treatment. The intensity depends on the location, the size, the extent of spread and the symptoms. Classic Hodgkin lymphoma is always treated with chemotherapy, possibly combined with radiotherapy. After the first two courses of treatment, a PET scan is performed to check how well the lymphoma responds to the chemotherapy. Lymph nodes that shrink quickly sometimes require less intensive treatment, in which case radiotherapy is omitted. Should the disease return, a second course of chemotherapy, and often radiotherapy as well, is usually provided. Autologous stem cell reinfusion is also an option. A lymphoma that has relapsed can sometimes be treated with smart drugs that specifically target and destroy the lymphoma cells.

The treatment of non-classic Hodgkin lymphoma is much milder. Sometimes it is sufficient to remove the affected lymph node, otherwise three short courses of chemotherapy are administered.

Chance of recovery

The survival rate of children with Hodgkin lymphoma is very high (90-95%). Even if the lymphoma has spread to organs and tissues beyond the lymphatic system, they stand an excellent chance of recovery. However, the treatment in that case is often longer and more intensive. Even if the lymphoma recurs, it can often be brought under control and the majority of children get better. However, it is still difficult to make predictions. Don't be influenced too much by statistics. Every child and every situation is unique.

Questions?

Children and teenagers with Hodgkin lymphoma are treated in the hematology-oncology department.