Hodgkin's Lymphoma—Child
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Definition
Hodgkin's lymphoma is a cancer of the lymph system. The lymph system is a series of tubes and nodes that run through the body. It contains a fluid that helps fight infections and move waste out of the body.

The cancer starts in a type of lymph cell called a lymphocyte. These cells spread throughout the lymph system. Eventually, the cells will make it harder for your body to fight infections. It is considered a very treatable form of cancer.

The Lymphatic System

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Causes
The exact cause is not known. A combination of genetic and environmental factors may play a role.

Risk Factors
Hodgkins is more likely to occur in males and people between ages 15-40 years, or over 55 years. Other factors that may increase your chance of Hodgkins lymphoma include:

  • Family history of Hodgkin’s lymphoma
  • History of Epstein-Barr virus the virus that causes mononucleosis
  • Weakened immune system such as HIV/AIDS
  • Exposure to certain chemicals such as formaldehyde
Symptoms
Hodgkin's lymphoma may cause:

  • Painless swelling of the lymph nodes in the neck, armpit, groin, or chest
  • Fatigue
  • Night sweating
  • Coughing
  • Unexplained fever
  • Weight loss
  • Itching
  • Decreased appetite
These symptoms can be caused by other less serious conditions. 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 liver and blood. The diagnosis will be confirmed by taking a sample of tissue and examining it for the presence of cancer or other abnormalities. The tissue samples will be taken through biopsies such as:

  • Lymph node biopsy—piece of lymph node removed for examination under a microscope
  • Bone marrow biopsy—a needle is inserted into a bone to sample the marrow cells with areexamed under a microscope
Imaging studies are used to evaluate lymph nodes and other tissues that may be affected. These may include:

Treatment
Treatment depends on the stage of the disease. The stage is determined by how far the cancer has spread and what organs are affected.

The healthcare team will work to make a treatment plan for your child. Treatment options may 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 a specific area to kill the cancer cells. In many cases, both chemotherapy and radiation are used.

Surgery
Surgery is not often used for Hodgkin's lymphoma. It may be effective if the cancer is isolated to just one lymph node. Surgery will remove the affected lymph node.

Transplantation
Treatment and the cancer itself can damage blood and lymph cells. Transplantation will help the body rebuild these cells after treatment. Transplant options may include:

  • 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. Once treatment is done, the stem cells are then placed back into the blood.
Prevention
There are no current guidelines to prevent Hodgkin's lymphoma because it is not known what causes it.




RESOURCES:
American Cancer Society

Leukemia and Lymphoma Society

CANADIAN RESOURCES:
Canadian Cancer Society

Lymphoma Foundation Canada

References:
Hodgkin’s lymphoma. American Cancer Society website. Available at: http://www.cancer.org/cancer/hodgkindisease/detailedguide/index. Accessed March 3, 2014.

Hodgkin lymphoma (HL). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 7, 2014. Accessed March 2, 2014.

Last Reviewed March 2014



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