Understanding Pediatric Lymphoma

Pediatric lymphoma is a cancer that begins in blood cells. Important things to know include:

  • Lymphoma is one of the most curable cancers in children.
  • Medical advances have made survival rates very high.
  • Scientists don’t know the cause of most childhood lymphomas.
  • Pediatric lymphomas include two main types, non-Hodgkin lymphoma and Hodgkin lymphoma. Each is treated differently.

What is pediatric lymphoma?

Lymphomas are cancers that begin in cells called lymphocytes. These infection-fighting cells circulate in blood and the lymph system.

The lymph system is a network of vessels, similar to blood vessels. It’s part of your child’s immune system and helps rid their body of toxins and infections.

Lymphomas happen when lymphocytes grow and multiply out of control.

The Lymph System

A diagram of a child’s lymph system with close-up images of a lymph node and bone marrow.
The lymph system includes a network of vessels, bean-shaped lymph nodes and organs. Infection-fighting cells called lymphocytes are made in bone marrow and other tissue. The cells circulate through the immune system in a fluid called lymph. Lymphoma happens when lymphocytes grow and multiply abnormally.

Types of pediatric lymphoma

There are two categories of lymphoma: non-Hodgkin lymphoma and Hodgkin lymphoma. Both are more common in adults than in children. But lymphoma is the most common cancer in teens age 15 to 19, and still makes up about 8% of cancers diagnosed in children younger than 15.

Hodgkin lymphoma, also called Hodgkin disease, happens when white blood cells called lymphocytes grow abnormally. These abnormal lymphocytes and other immune cells cause swollen lymph nodes in the body.

Non-Hodgkin lymphoma has many subtypes. The three found most often in children are:

  • B-cell lymphoma begins in immune cells called B cells. Nearly half of all childhood NHL cases are this subtype.
  • Lymphoblastic lymphoma begins in immune cells in the thymus gland or bone marrow called T cells. It can appear similar to leukemia. About one in three children with NHL has this subtype.
  • Anaplastic large cell lymphoma most often begins in T cells that circulate throughout the body. It is the rarest type of childhood lymphoma.

Who gets pediatric lymphoma?

Lymphoma is the most common childhood cancer after leukemia and brain tumors.

Nearly 900 children younger than 15 are diagnosed with lymphoma in the United States each year. In children age 15 to 18, Hodgkin lymphoma is more common.

Risks factors include:

  • Age: NHL happens more often in children ages 10 to 15. Hodgkin lymphoma happens more often in older teenagers. Either type is unusual in kids younger than 3.
  • Gender: NHL is up to three times more common in boys. Hodgkin lymphoma is slightly more common in boys and young men.
  • Race: NHL is more common in white children.
  • Health history: Children with conditions that affect the immune system may have a higher risk of developing NHL.

What causes pediatric lymphoma?

Doctors don’t know what causes most childhood lymphomas. Most children who develop it haven’t had a condition that may be linked to lymphoma. That means there’s nothing anyone could have done to prevent it.

Some research links the Epstein-Barr virus, the virus that causes mononucleosis, to DNA changes that may lead to lymphoma.

Symptoms of pediatric lymphoma

Common symptoms of lymphomas include:

  • Swollen lymph nodes, including in the neck, armpit or groin
  • Swelling or pain in the abdomen
  • Trouble swallowing
  • Trouble breathing
  • Swelling in the face
  • Weakness, tiredness
  • Weight loss
  • Night sweats
  • Long-lasting fever

Pediatric lymphoma staging

Doctors use staging to measure how much cancer has spread. Staging is based on a physical exam, scans and analysis of tissue samples (biopsy).

We use a system that divides non-Hodgkin and Hodgkin lymphoma into limited stage (Stages I and II) or advanced stage (Stages III and IV), depending on how far the cancer has spread beyond your child’s lymph nodes.

Doctors generally use the same treatment approaches for Stages I and II and for Stages III and IV. Learn more about lymphoma staging at the OHSU Knight Cancer Institute.

Pediatric lymphoma survival rates

In the last few decades, doctors have made huge progress in treating childhood lymphoma. Most children and young adults diagnosed with lymphoma are long-term survivors after treatment.

For people younger than 20 with:

  • Non-Hodgkin lymphoma, the five-year survival rate is nearly 89%.
  • Hodgkin lymphoma, the five-year survival rate is more than 97%.

While the outlook is good for childhood lymphoma, it’s important to remember that survival rates are averages. They can’t predict the outcome for each individual case.

Learn more about lymphoma from the National Cancer Institute.

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‘Ellie’s Army’

When soccer captain Ellie found out she had Hodgkin lymphoma, her whole team stepped up to arrange fundraisers and events to help her family.