What Causes Childhood Hodgkin Lymphoma Disease?
Generally speaking, childhood cancer, like adult cancer, is caused by the uncontrolled replication of our body’s own cells. In a healthy body, cells grow and divide only when needed to replace old or damaged cells. When cancer develops, old cells do not die and/or new cells grow when they aren’t required; as these new cells divide without stopping, they can develop into a tumor or other form of cancer. Childhood Hodgkin lymphoma, making up approximately 6% of all childhood cancers diagnosed in the United States, is a form of cancer that usually begins in the white blood cells that the body uses to fight off viruses, bacteria, and other foreign invaders.
What triggers the abnormal growth and replication of white blood cells, in the case of childhood Hodgkin lymphoma? Unfortunately, scientists do not yet fully understand why some cells in a child’s body begin to replicate abnormally and cause cancer. Thus, we do not know what causes childhood Hodgkin lymphoma or most other forms of childhood cancer.
In some cases of childhood Hodgkin lymphoma, scientists believe there may be a causal link between Hodgkin lymphoma and infection with the Epstein-Barr virus (EBV). Between 15% and 20% of adolescents and young adults diagnosed with Hodgkin lymphoma also test positive for infection with EBV; that percentage is even higher in children younger than 10 years of age. In these cases, EBV genetic material has been discovered in the Reed-Sternberg cells linked to most forms of Hodgkin lymphoma. The gene changes in the Reed-Sternberg cells caused by the presence of EBV genetic material may help these cells live longer than normal, replicate abnormally quickly, and/or develop extra cytokines that may, in turn, spark further growth of the Reed-Sternberg cells.
It would not be accurate to state, however, that EBV infection “causes” childhood Hodgkin lymphoma. Most children, adolescents, and young adults who contract EBV do not develop Hodgkin lymphoma and many diagnosed cases of Hodgkin lymphoma do not involve EBV infection. Thus, we do not know what triggers the development of Hodgkin lymphoma, nor do scientists fully understand the potential connection between EBV and childhood Hodgkin lymphoma.
What Are the Symptoms of Childhood Hodgkin Lymphoma?
Because childhood Hodgkin lymphoma is a cancer of the lymph system, the most common symptom is one or more swollen lymph nodes. Lymph nodes are bean-sized collections of lymphatic tissue in the neck, armpit, chest, and groin. A lump in one of these areas that does not go away over time, gets larger, and/or spreads to additional areas of the body may be an indicator of childhood Hodgkin lymphoma. Swollen lymph nodes caused by Hodgkin lymphoma in children are not usually painful or uncomfortable. However, swollen lymph nodes in the chest may press on the lungs and/or trachea (windpipe), causing coughing or breathing trouble, especially when lying down.
It is important to note, however, that most swollen lymph nodes are caused by infection, not Hodgkin lymphoma, as the lymph nodes are responsible for filtering lymph in the blood responsible for fighting viruses and bacteria in the body. Swollen lymph nodes caused by infection are usually uncomfortable or painful to the touch and will resume their normal size once the infection is under control.
Other symptoms of childhood Hodgkin lymphoma include:
- Itchy skin
- General fatigue
- Fever of unknown cause (unrelated to infection)
- Unexplained weight loss/anorexia (10% of body weight within 6 months before diagnosis)
- Night sweats
Three of these symptoms—unexplained fever, unexplained weight loss, and drenching night sweats—are classified as B symptoms and used to determine the “stage” of the disease, as well as to assign risk. Generally speaking, patients who present with B symptoms are at higher risk and therefore require a more intensive treatment protocol.
About American Childhood Cancer Organization
American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer. And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.
For additional information about childhood cancer or on ACCO, or to order resources for you or your child, please visit our website at www.acco.org.