Cancer Center

Hodgkin's Lymphoma in Children

The Pediatric Leukemia and Lymphoma Program at the Cancer Center at The Children's Hospital of Philadelphia consists of a multidisciplinary team of experts in treating Hodgkin's lymphoma. Many of our oncologists are also on the forefront of researching new therapies and advances in the treatment of this type of cancer.

What is Hodgkin's lymphoma?

The term lymphoma refers to a group of cancers of the lymph system. The lymph system is made up of vessels throughout the body that carry lymph (the colorless fluid from body tissue) as well as organs such as lymph nodes, the spleen and the thymus. These tissues produce and store infection-fighting cells. Certain parts of other organs such as the tonsils, stomach, small intestine and skin are also part of the lymph system.

Lymphomas can start in almost any part of the body, but they usually begin in the primary lymphatic organs. Like other cancers, lymphomas can also spread to other body organs.

Lymphomas are classified according to the appearance of the cancer cells under the microscope and how they behave when special laboratory tests are applied to them. Treatment decisions are based on the results of these and other studies.

Who is diagnosed with Hodgkin's lymphoma?

Lymphomas (including Hodgkins lymphoma and non-Hodgkin's lymphoma), are the third most common cancer in children.

Children of all ages are diagnosed with lymphomas, but Hodgkin's lymphoma occurs more often in adolescents than younger children, and it is more common in boys than girls.

There are no known environmental toxins that increase the risk of lymphoma in children. However, children who are born with conditions that affect the immune system are more likely to develop lymphomas. Having a sibling with lymphoma also slightly raises a child's risk. Prior infection with the Epstein-Barr virus (the virus that causes infectious mononucleosis) is also associated with a greater risk for lymphoma.

What are the signs and symptoms of Hodgkin's lymphoma?

Signs and symptoms of Hodgkin's lymphoma include:

How do we diagnose Hodgkin's lymphoma in your child?

Your child's doctor will do a physical exam — including checking for signs of the disease such as lumps in lymph nodes — and take a thorough medical history. If Hodgkin's lymphoma is suspected, your child will undergo several or all of the following diagnostic tests to establish the diagnosis:

After the tests are completed, members of the oncology team will discuss the results with you at a family meeting. Your child's doctor will then discuss the treatment options for your child and make recommendations.

How is Hodgkin's lymphoma treated?

The specific options for treatment will depend on your child, the extent of the tumor and the results of studies on tumor tissue. The doctors may discuss a treatment plan with you that is a clinical trial run by The Children's Oncology Group. Treatment may consist of chemotherapy (drugs that destroy cancer cells) and sometimes radiation therapy.

Your child's chemotherapy may be given during an inpatient hospital stay or, more likely, in the oncology outpatient day hospital. Radiation treatments will be given on an outpatient basis, usually at the Center for Advanced Medicine (across the street from Children's Hospital). Follow-up studies and scans such as CT and PET will be repeated at intervals during treatment and for a specific period following treatment. We will try to schedule these as outpatient procedures along with your clinic appointments.

During your child's hospitalization and your visits to the Oncology Clinic, the doctors, nurses and social workers will be working with you and your child to understand the disease, its treatment and how to care for special needs at home.

Although Hodgkin's lymphoma is a serious disease, most newly diagnosed children and adolescents can be cured with modern treatment.

Late effects/cancer survivorship

Some children treated for Hodgkin's lymphoma develop complications years later. Our Cancer Survivorship Program provides information about the potential long-term effects of the specific treatment your child received, including ways of monitoring and treating these effects.


Reviewed by:
Leslie Kersun, MD, MSCE, The Children's Hospital of Philadelphia
Date: November 2009

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