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Tag Archives: Childhood Hodgkin Lymphoma

Treating Childhood Hodgkin Lymphoma

i-KVDjmX3Childhood Hodgkin lymphoma has proven to be particularly sensitive to both chemotherapy and radiation therapy. Therefore, for most children diagnosed with this type of childhood cancer, treatment will likely involve some combination of both modalities. Surgery is rarely ever used to remove Hodgkin lymphoma tumors, although surgical procedures may be required to facilitate chemotherapy and radiation therapy protocols. The exception to this general rule may be found in the treatment of some cases of localized lymphocyte-predominant Hodgkin lymphoma, where surgery may prove a more effective course of treatment than chemotherapy and/or radiation.

Both chemotherapy and radiation therapy can have severe and long-lasting health effects (so-called “late effects”). Therefore, the goal of your child’s treatment plan will be to attempt to create a delicate balance between enough treatment to eliminate the cancer and prevent the growth of new cancer cells and minimizing both short- and long-term damage to your child’s growing body. Moreover, the oncology team will also consider your child’s age and medical history, as well as the “stage” of the disease (how far the disease has progressed and spread from the site of the original tumor), whether diagnosis occurred with so-called “B” symptoms (fever, night sweats, and/or unexplained weight loss), and an assessment of risk.

Thus, the description of treatment options below are generalized and for informational purposes only; your child’s treatment course, including intensity and duration, will likely be a unique combination of these or other options depending on the unique factors in your child’s case.

Chemotherapy for Childhood Hodgkin Lymphoma

Chemotherapy involves targeting cancer cells with toxic drugs designed to kill the cells as they replicate and divide. Because cancer cells grow, replicate, and divide more quickly than normal, non-diseased cells, they are more susceptible to the harmful effects of the drugs than are healthy cells. Still, healthy cells are affected by chemotherapy as well, leading to both short- and long-term health effects. Moreover, different types of chemotherapy agents can have different types of short- and long-term health effects. Therefore, your child’s chemotherapy protocol will likely involve a combination of different drugs given in as low dosages as possible.

Most chemotherapy protocols for childhood Hodgkin lymphoma will involve some unique mixture of three standardized drug combinations:

  • ABVD (the most common treatment protocol for adult Hodgkin lymphoma):
  • Adriamycin® (doxorubicin)
  • Bleomycin
  • Vinblastine
  • Dacarbazine (DTIC)

 

  • BEACOPP
  • Bleomycin
  • Etoposide (VP-16)
  • Adriamycin (doxorubicin)
  • Cyclophosphamide (Cytoxan®)
  • Oncovin® (vincristine)
  • Procarbazine
  • Prednisone

 

  • Stanford V
  • Doxorubicin (Adriamycin)
  • Mechlorethamine (nitrogen mustard)
  • Vincristine
  • Vinblastine
  • Bleomycin
  • Etoposide
  • Prednisone

 

Radiation Therapy

Radiation therapy works by targeting cancer cells with high-energy beams, usually composed of x-rays or protons. The beams of energy damage the DNA inside the cancer cells and prevent it from replicating itself. In most cases of childhood Hodgkin lymphoma, the preferred method of treatment is a combination approach incorporating both radiation therapy and chemotherapy. By combining both treatment modalities, the goal is to effectively reduce the size of the tumor and prevent the growth of new cancer cells while minimizing the risk of both short- and long-term side effects.

As with chemotherapy, radiation damages healthy cells as well as cancerous cells. For young adults who are past puberty and have stopped growing, radiation therapy may play a more substantial role in treatment for childhood Hodgkin lymphoma than chemotherapy. However, because the bodies of younger children are still growing and developing, the risk of long-term damage from radiation therapy is greater. Therefore, chemotherapy is the preferred method of treatment, with radiation generally used as a supplemental treatment designed to prevent the cancer from recurring.

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 the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

How is Childhood Hodgkin Lymphoma Detected?

As with most types of childhood cancer, there is no method of early detection for childhood Hodgkin lymphoma. Childhood Hodgkin lymphoma does cause detectable symptoms; however, the symptoms are usually general and vague, and may in fact be caused by a variety of routine childhood complaints.

Symptoms of childhood Hodgkin lymphoma may include:

  • Fatigue
  • Unexplained fever
  • Unexplained and significantly weight loss (defined as at least 10% of body weight within 6 months of diagnosis)
  • Night sweats
  • Itchy skin

The most common symptom of childhood Hodgkin lymphoma is one or more swollen lymph node(s) in the neck, armpit, chest, and/or groin area. As with the other symptoms listed above, however, a swollen lymph node may—and very often does—have other causes than childhood Hodgkin lymphoma. Swollen lymph nodes are usually caused by infection because the lymph nodes are responsible for helping the body clear the blood of foreign viruses and bacteria. Swollen lymph nodes caused by infection are usually uncomfortable and painful to the touch, and can be treated with antibiotics.

If the lump caused by the swollen lymph node does not diminish over time, does not respond to antibiotics, and/or is not uncomfortable or painful, or if your child has a swollen lymph node and one or more of the symptoms noted above, your child’s pediatrician may suspect the presence of Hodgkin lymphoma and suggest additional testing.

How is Childhood Hodgkin Lymphoma Diagnosed?

Once infection has been ruled out as the cause of any swollen lymph nodes, the next step in determining whether your child has childhood Hodgkin lymphoma is to perform a biopsy on the affected lymph node tissue. A biopsy involves removing some or all of the affected tissue and examining it under a microscope to detect the presence of cancerous cells. Depending on the location of the lump, the biopsy can be performed under local anesthesia (for lumps located near the surface of the skin) or under general anesthesia (for lumps located deeper inside the abdomen or chest).

How is Childhood Hodgkin Lymphoma DiagnosedThere are two different types of biopsies that can potentially be used to diagnose childhood Hodgkin lymphoma. The preferred method is an excisional or incisional biopsy, because in most cases it involves removal of enough tissue to diagnose the exact type of Hodgkin lymphoma as well to help in staging. In an excisional biopsy, the entire lymph node is removed. During an incisional biopsy, a small piece of the swollen lymph node is removed.

A needle biopsy is less invasive than an excisional or incisional biopsy, but is usually not preferred as it may not provide sufficient tissue for an accurate diagnosis. A fine needle aspiration biopsy utilizes an extremely small, hollow needle to remove a small amount of fluid and tissue, while a core needle biopsy uses a larger needle and removes a slightly larger amount of fluid and tissue.

Once childhood Hodgkin lymphoma has definitely been diagnosed with a biopsy, your child may have to undergo additional testing to determine the specific type of Hodgkin lymphoma and the stage of the disease (how far it has progressed). This information will help determine the recommend course of treatment. Additional tests may include:

  • Bone marrow aspiration: a sample of bone marrow is removed from the inside of the pelvic bone (usually); in some cases, the test may involve removing a small sample of bone as well. A biopsy of the bone and/or marrow will indicate whether cancerous cells have spread to the marrow.
  • Immunohistochemistry: this laboratory test determines whether certain proteins are present on the cancerous cells, in order to determine the exact type of Hodgkin lymphoma, for instance, or to diagnose non-Hodgkin lymphoma or another disease entirely.
  • Imaging tests, such as chest x-ray, CT scan, and/or PET scan: While not generally used during diagnoses, imaging tests can be used to determine the stage of the disease and whether treatment is working. In some cases, imaging tests may be used to detect and/or biopsy enlarged lymph nodes not readily apparent with an easily visible lump, such as those located in the chest.

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 the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

 

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?

Childhood Hodgkin Lymphoma DiseaseBecause 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.

 

For additional information about childhood cancer or on the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

Childhood Hodgkin Lymphoma Disease: A brief introduction

Image result for Childhood HodgkinChildhood Hodgkin lymphoma, similarly to adult Hodgkin lymphoma, is a type of malignant cancer of the lymph system, which forms a critical part of the immune system our bodies use to fight disease. Specifically, Hodgkin lymphoma usually begins in lymphocytes, a type of white blood cell responsible for fighting bacteria, viruses, and other foreign invaders. Hodgkin lymphoma makes up about 6% of all childhood cancers. Today, the prognosis for children with Hodgkin lymphoma is significantly higher than even a decade ago, with the five-year survival rate between 90-95%.

Risk Factors for Childhood Hodgkin Lymphoma

A “risk factor” is anything that increases the odds of developing a disease such as cancer. For example, smoking is defined as a risk factors for lung cancer. Unlike many adult cancers, childhood cancers are rarely, if ever, linked to specific risk factors, especially lifestyle choices. Childhood Hodgkin lymphoma does have several identified risk factors. It is important to note, however, that not all children with these specific risk factors develop Hodgkin lymphoma, nor can most cases of Hodgkin lymphoma be traced to these risk factors. As with all childhood cancers, the cause of Hodgkin lymphoma is unknown.

Generally speaking, infection with one of two viruses known to cause immunodeficiency—Human immunodeficiency virus (HIV), the virus that causes AIDS, and the Epstein-Barr virus—are considered to be risk factors for childhood Hodgkin lymphoma. Scientists and researchers are unclear as to why there appears to be a link between Epstein-Barr and Hodgkin lymphoma.

Other risk factors for childhood Hodgkin lymphoma include:

  • Age: Hodgkin lymphoma is more common in teens and young adults than in younger children
  • Gender: more girls than boys develop Hodgkin lymphoma during adolescence, but in young children, boys are significantly more likely to develop this form of cancer than girls
  • Family history: siblings, especially identical twins, have a slighter higher risk for Hodgkin lymphoma, although most children with Hodgkin lymphoma do not have a family history
  • Socioeconomic status: children from a higher socioeconomic background have a slighter higher risk of developing Hodgkin lymphoma, although the link is unknown. Some research speculate that children from more affluent families are more likely to contract Epstein-Barr.

Can Childhood Hodgkin Lymphoma Be Prevented?

Because the development of childhood Hodgkin Lymphoma is not linked to lifestyle factors that can cause some adult cancers, there is no known way to prevent childhood Hodgkin lymphoma. The one exception relates to the potential development of Hodgkin lymphoma as a secondary cancer stemming from treatment of a different form of childhood cancer with radiation therapy and/or chemotherapy. However, for children battling cancer, each child’s oncology team must weigh the need for intensive treatment to fight the primary cancer with the risk of causing secondary cancers and/or other long-term health problems. As with all childhood cancers, this exception highlights the critical need to develop new, more effective, and less toxic treatment options designed specifically for kids with cancer.

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 the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

ACCO