What is Childhood Hodgkin Lymphoma?
Hodgkin lymphoma is a specific type of cancer that starts within white blood cells called lymphocytes found in the lymph (or lymphatic) system. Hodgkin lymphoma (HL) can be diagnosed in individuals of all ages, but is most prevalent in adolescents between the ages of 15-19 and again in adults older than 55. It is rare in children under the age of five. When classified as a type of childhood cancer, HL accounts for about 6% of all childhood cancers; however, most statistics relating to HL do not distinguish between diagnoses in children, adolescents, and adults.
There are two different types of Hodgkin lymphoma: classical Hodgkin lymphoma accounts for 9 out of 10 cases, with a more rare form known as Nodular lymphocyte-predominant Hodgkin lymphoma accounting for about 1 out of 10 cases. Classical Hodgkin lymphoma is characterized by the presence of a specific cancer cell known as Reed-Sternberg cells. As it name implies, Nodular lymphocyte-predominant Hodgkin lymphoma is characterized instead by lymphocyte-predominant cells. Both forms are distinct from non-Hodgkin lymphoma.
Expected Life Span: Outcomes and Prognosis of Childhood Hodgkin Lymphoma
As with most types of cancers, prognosis statistics for Hodgkin lymphoma are generally given in terms of “five-year survival rates”, which provides an average of the number of individuals who are alive five years after diagnosis. As always, however, these statistics are general: your child’s specific outlook will depend specifically on the unique nature of your child’s diagnosis, the stage of the disease at the time of diagnosis, and the assessment of risk at diagnosis. Generally speaking, however, the outlook for HL is favorable; it is usually fairly responsive to both chemotherapy and radiation therapy and was the first type of cancer to be “cured” with radiation therapy alone or in combination with chemotherapy.
When discussing five-year survival statistics for HL, the National Cancer Institute utilizes a staging system known as SEER with three distinct groupings. The most recent data in the SEER database is from 2008 to 2014; however, in 2014 most oncologists and researchers began utilizing a different staging system known as the Lugano classification. Therefore, we have provided five-year survival statistics here using the SEER system, but will discuss staging below as categorized by the more recent Lugano classification, as that is more likely what oncologists will use for a current diagnosis.
- Localized: limited to one lymph node cluster or lymphoid organ, or has spread to only one organ beyond the lymph system. The 5-year survival rate for localized HL is 92%.
- Regional: has spread from one lymph node area to an organ close by, is located in two or more lymph node clusters but only on one side of the body, or is “bulky”. The 5-year survival rate for regional HL is 93%.
- Distant: has spread to a more distant part of the body such as the lungs or bone marrow, or to lymph node clusters above and below the diaphragm. The 5-year survival rate for distant HL is 78%.
Hodgkin Lymphoma Stages: Lugano Classification
Today, oncologists have moved away from the less descriptive groupings used in the SEER database towards a more descriptive system known as the Lugano classification system. In either case, however, the stage of the disease at diagnosis helps determine the extent to which the cancer has spread, the intensity of required treatment, and the long-term outlook.
The Lugano classification involves a three-tied staging system:
The first step involves a letter classification: A, B, E, or S. HL with a “B” classification is more advanced and usually requires more intensive treatment:
- A: no symptoms at diagnosis
- B: “B” symptoms at diagnosis: fever, 10% or more weight loss, and/or night sweats
- E: the cancer has spread to an organ or tissue that is next to but not part of the lymph system
- S: cancer has spread to the spleen
The second step involves four distinct phases: I, II, III, and IV:
- Stage I: The cancer is found in one or more lymph nodes, but only one lymph node cluster.
- Stage II: The cancer is found in two or more lymph node clusters, either above or below the diaphragm.
- Stage III: The cancer is found in one or more lymph node cluster both above and below the diaphragm.
- Stage IV: The cancer is found in one or more organs and in lymph nodes adjacent to those organs, or is in only one organ but has spread to lymph nodes distant from that organ, or is in the liver, lung, or bone marrow.
The third step involves assigning a risk group, usually stemming from whether the tumor can be considered “bulky”, defined as five centimeters or larger, as well as the presence of “B” symptoms:
- Low risk: Stage I or Stage II with no bulky tumors or “B” symptoms
- Intermediate risk: Stage I or II with either bulky tumors or “B” symptoms; or Stage III and IV without any “B” symptoms
- High risk: Stage III or IV accompanied by “B” symptoms
More about Childhood Hodgkin Lymphoma Cancers:
- About Childhood Hodgkin Lymphoma Cancer – Detection and Diagnosis
- Causes, Risk Factors, and Prevention of Childhood Hodgkin Lymphoma Cancer
- What are the signs and symptoms of Childhood Hodgkin Lymphoma Cancer?
- Childhood Hodgkin Lymphoma Cancer Treatment
- Childhood Hodgkin Lymphoma Cancer – Stages and Prognosis
- What is the expected life span of Childhood Hodgkin Lymphoma Cancer?
- After Treatment – Living as a Childhood Hodgkin Lymphoma Cancer Survivor
Learn More About the Different Types of Childhood Cancers:
- Childhood Brain Tumor Cancer (Brain Stem Tumors)
- Spinal Cord Tumor Cancer
- Childhood Neuroblastoma Cancers
- Childhood Hodgkin Lymphoma Cancers
- Non-Hodgkin Lymphoma Cancers
- Wilms tumor (Kidney Tumors)
- Bone cancer (including osteosarcoma and Ewing sarcoma)
- Leukemia Cancers: Acute lymphocytic (lymphoblastic) leukemia (ALL) Acute myelogenous leukemia (AML); Juvenile myelomonocytic leukemia (JMML)
- Hepatoblastoma (Liver Cancer)
- Rhabdoid Tumors
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.