When Your Child Has Hodgkin Lymphoma

Your child has been diagnosed with Hodgkin lymphoma. You are likely feeling shocked and scared. You are not alone. Support and treatment are available. Your child’s healthcare team will help you as you make important decisions regarding your child’s health.

What is Hodgkin lymphoma?

Hodgkin lymphoma, also called Hodgkin disease, is a cancer of the lymphatic system. The lymphatic system is part of the immune system, which helps the body fight infection. The lymphatic system includes:

• Lymph. Infection-fighting fluid made mostly of a certain type of white blood cell called lymphocytes.

• Lymph nodes. Small, bean-shaped organs that filter lymph and store white blood cells. Lymph nodes are grouped together all over the body. Some areas where they are found are the neck, armpit, and groin.

• Bone marrow. Soft tissue found in the center of bones. Blood cells are made in the bone marrow.

• Spleen. Organ that stores certain lymphocytes and filters the blood. It’s located under the ribs on the left side of the body.

• Certain other organs and body tissues. Lymph tissue is also found in other parts of the body, such as the thymus, tonsils, and digestive tract.

With Hodgkin lymphoma, cancer cells form in the lymphatic system. When the cancer cells group together, they form a tumor. The tumor can spread (metastasize) to another part of the body, such as the lungs. Cancer cells make it hard for the body to fight infection and can cause other health problems.

Who gets Hodgkin lymphoma?

Children can get Hodgkin lymphoma at any age. But teens are affected most often. Hodgkin lymphoma is not contagious. This means your child can’t pass it to another person.

What causes Hodgkin lymphoma?

Hodgkin lymphoma occurs when white blood cells grow abnormally (mutate). Experts don’t know what causes this to happen. Most often, the cause of cancer in children is not known. In rare cases, certain factors might play a role. This includes being exposed to certain viruses.

What are the symptoms of Hodgkin lymphoma?

Some common symptoms of Hodgkin lymphoma include:

• Fever

• Night sweats

• Weight loss

• Tiredness

• Itchy skin

• Swollen lymph nodes in the neck, chest, armpits, or groin

Your child may have had some of these symptoms, or other symptoms.

How is Hodgkin lymphoma diagnosed?

Your child’s healthcare provider will do a physical exam. You will be asked about your child’s health history. Your child may also have 1 or more of the following tests:

• Blood tests.  Blood samples are taken and checked under a microscope.

• Imaging tests. These offer detailed images of areas inside the body. They may include a chest X-ray, CT scan, MRI, or PET scan.

• Lymph node biopsy. A sample of lymph node tissue is taken and looked at under a microscope.

• Bone marrow aspirations and biopsies. Samples of bone marrow from the hip bones are taken and examined.

How is Hodgkin lymphoma treated?

The goal of treatment is to destroy cancer cells. Your child will get treatment based on his or her stage of Hodgkin lymphoma. Treatments may be combined. Your child may need one or more of the following treatments:

• Chemotherapy, or chemo. This destroys cancer cells using powerful, cancer-fighting medicines. Several chemo medicines may be used. They are often given through an IV (intravenous) tube into a vein in the arm or chest. Or they may be given by mouth or injection.

• Radiation therapy. This destroy cancer cells with high-energy X-rays.

• High-dose chemotherapy and stem cell transplant. Higher doses of chemotherapy can’t be used alone because they damage the bone marrow, where new blood cells are made. But this treatment can be followed by a stem cell transplant. The transplant replaces the cells in the bone marrow with young blood cells, called stem cells.

• Monoclonal antibody therapy. This treats the cancer with special man-made versions of immune system proteins.

Supportive treatments

The goal of supportive treatments is to protect your child from infection, prevent discomfort, and bring the body’s blood counts to a healthy range. During treatment, your child may be given medicines (antibiotics) to help prevent and fight infection. Anti-nausea and other medicines may also be given. These help ease side effects caused by treatment. Your child may have a blood transfusion to restore the blood cells destroyed by treatment. For this, blood is taken from a donor and stored until your child is ready to receive it. 

What are the long-term concerns?

With treatment, Hodgkin lymphoma can usually be cured. But chemotherapy and radiation may cause some problems. These include damage to certain organs. Later in life, your child may have second cancers, but this is very rare. Children who get certain chemotherapy or radiation therapy may have problems having a baby (infertility) as an adult. So your child’s health will need to be checked during his or her whole life. This may include clinic visits, blood tests, imaging tests, heart ultrasounds, and lung function tests.

Coping

A cancer diagnosis for your child is scary and confusing. It’s important to remember that you are not alone. Your child’s healthcare team will work with you and your child throughout your child’s illness and care. You may also wish to seek information and support for yourself. Doing so can help you cope with the changes cancer brings. Learning about and talking with others who also have a child with cancer may help you and your family cope. Some helpful resources include:

• Lymphoma Research Foundation
  www.lymphoma.org

• Children's Oncology Group
  www.childrensoncologygroup.org

• The Leukemia & Lymphoma Society
  www.lls.org