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Non-Hodgkin's Lymphoma

Non-Hodgkin lymphoma is a form of lymph node cancer. Every year, approximately 20-30 children in the Netherlands are diagnosed with non-Hodgkin lymphoma. Most of those children are between 5 and 12 years old. The disease is more common in boys than in girls. Non-Hodgkin lymphoma involves uninhibited division and growth of lymphocytes, a 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. There are various types of non-Hodgkin lymphoma.

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

Causes

Little is known about what causes non-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

A lymphoma in the abdomen can cause nausea and sometimes breathing problems as well. Symptoms related to a lymphoma in the neck or throat, nose and ears are difficulty breathing and swallowing and persistent or recurring colds or sinus infections. A lymphoma in the chest cavity causes symptoms such as coughing and tightness of the chest and sometimes blocked jugular veins and a swollen, bluish face (cyanosis). All types of lymphomas can cause severe night sweats, persistent fever, or weight loss.

How is Non-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 performed. Bone marrow and cerebrospinal fluid samples are collected as well. These procedures are performed under sedation.

Treatment

Children with non-Hodgkin lymphoma are treated according to a protocol drawn up by national and international experts. The treatment depends on the type and location of the lymphoma, its spread throughout the lymphatic system and possibly into tissues and organs. Your child will usually only receive chemotherapy. Only in the event of an acute situation, such as an intestinal blockage, will surgery be performed on your child. Surgery is always followed by chemotherapy. Radiotherapy does not apply, except when the disease has spread to the brain or the testicles. Lymphomas often respond well to chemotherapy, shrinking soon after the first courses of treatment. Still, your child needs lengthy treatment to kill all tumor cells. If the disease returns during or after treatment, your child will receive more chemotherapy, possibly followed by high dose chemotherapy with stem cell reinfusion. For some types of lymphomas, there are smart drugs that specifically target and destroy the lymphoma cells.

Chance of recovery

The survival rate of children with non-Hodgkin lymphoma is 70%-90%. In the event that the tumor has spread to organs and tissues beyond the lymphatic system, that percentage can be lower and more intensive treatment is often required. The disease is more difficult to control should it recur. Children with large cell anaplastic lymphoma usually stand a good chance of recovery, even if the tumor comes back. It is difficult to make predictions. Don't be influenced too much by statistics. Every child and every situation is unique.

Questions?

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