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Treatment Options for Childhood Non-Hodgkin Lymphoma (NHL)

Childhood Non-Hodgkin Lymphoma Cancer Treatment


Childhood Non-Hodgkin Lymphoma Cancer TreatmentNon-Hodgkin Lymphoma (NHL) forms within the body’s immune system, specifically within a type of white blood cell called a lymphocyte (B cells or T cells). Although there are three distinct types of NHL in children, there are two common characteristics of this particular form of cancer that must be taken into account when developing an appropriate treatment plan. First, NHL in children is almost always considered “high grade”, meaning that it is likely to grow quickly and aggressively. Second, NHL in children is considered diffuse, meaning it is likely to be found throughout the body. Because of these two characteristics, most oncologists start with the assumption that there are more cancerous cells present than can be detected with imaging and blood tests.

Because of the diffuse nature of Non-Hodgkin Lymphoma, chemotherapy (often called “chemo” for short) is usually the most effective treatment option. Chemotherapy involves targeting the cancerous cells with specific combinations of anti-cancer drugs. In most cases, the drugs are administered in pill form and/or delivered directly into the blood stream through an IV in order to kill cancerous cells throughout the body. In some cases, chemotherapy drugs may be administered directly into the spinal fluid (called intrathecal chemo) in order to target cancer cells that may have spread into the brain and/or spinal cord. NHL usually responds well to chemotherapy.

Although chemotherapy is—in general—the preferred treatment option for children with NHL, the specific combination and dosages of chemo drugs and the duration of treatment are unique to each child. The intensity of treatment will depend in large part on the type and stage of the lymphoma, as well as the general health of the child and how well the lymphoma responds to treatment. Generally speaking, Stage III and Stage IV NHL will require more intensive chemotherapy than Stage I or II NHL, and may involve some limited radiation therapy as well. Except in the case of Burkitt lymphoma, where surgery may be used to remove a tumor growing in one specific area of the body, surgery is almost never effective against this type of diffuse cancer, and therefore only rarely utilized as part of the treatment plan.

About Chemotherapy for Non-Hodgkin Lymphoma

Chemotherapy treatment for Non-Hodgkin Lymphoma is usually administered in three distinct phases.

  • Induction: The initial phase of chemo is designed to eliminate 99% of cancer cells in order to achieve “remission” (“remission” is not the same as a “cure”). Induction usually lasts for about a month—with daily and/or weekly treatments—and can be extremely intense, especially for Stage III and Stage IV diagnoses.
  • Consolidation (also called intensification): Often even more intense than the initial induction phase, consolidation is intended to kill any remaining cancerous cells and inhibit the growth of new, drug-resistant cancer cells. This phase of treatment usually lasts one to two months, or longer if necessary.
  • Maintenance: If the lymphoma responds well to induction and consolidation, most children will undergo a maintenance phase to prevent the cancer from returning. The maintenance phase is usually much less intensive, involving the administration of chemotherapy for brief periods every 4-8 weeks or so. Maintenance can last up to 2 years, or perhaps even longer, depending on the intensity of the treatment plan and how well the lymphoma responds to treatment.

Because Non-Hodgkin Lymphoma is considered a “high grade” type of cancer that grows quickly and aggressively, it is important to start chemotherapy as soon as possible after diagnosis. Moreover, if the lymphoma is diagnosed as Stage III or Stage IV where the cancer cells are growing and replicating quite quickly, chemotherapy will be more intensive, requiring short treatment cycles with less rest in between each cycle. Stage III and Stage IV cancers will also almost always require intrathecal chemotherapy, and may involve radiation therapy as well, especially if cancer cells have definitely been found in or near the spinal cord and/or brain.

More about Childhood Non-Hodgkin Lymphoma Cancers:

Learn More About the Different Types of Childhood Cancers:

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About American Childhood Cancer Organization

The American Childhood Cancer Organization was founded in 1970 by parents of children and adolescents diagnosed with cancer. As the nation’s oldest and largest grassroots organization dedicated to childhood cancer, ACCO is committed to shaping policy, supporting research, raising awareness, and providing free educational resources to kids with cancer, survivors, and their families. Additionally, ACCO is the sole U.S. member of Childhood Cancer International (CCI) and has helped support more than half a million families over the past 50 years. Help make childhood cancer a national health priority because kids can’t fight cancer alone®

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