Now Know Different Types of Lymphoma in Children

Lymphoma is the third most common type of cancer in children, accounting for approximately 10-12% of all pediatric cancers. It originates in the lymphatic system, a critical part of the immune system that includes lymph nodes, the spleen, the thymus gland, and bone marrow. Types of Lymphoma occur when lymphocytes, a type of white blood cell, grow uncontrollably, leading to the formation of tumors in the lymphatic tissues.

Lymphoma in children is generally divided into two main categories: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Both types are further classified into subtypes based on the characteristics of the cancer cells and the progression of the disease. This article provides an in-depth overview of the different types of Lymphoma in children, their symptoms, diagnosis, treatment options, and prognosis. (Source)

Also, read: Now Know Different Types of Bone Cancer in Children

What Is Lymphoma?

Lymphoma is a type of cancer that starts in the lymphocytes, the immune cells responsible for protecting the body against infections. The disease can develop in various parts of the lymphatic system and can also spread to other organs. In children, lymphoma can occur at any age but is more commonly diagnosed in adolescents. (Source)

Types of Lymphoma in Children

1. Hodgkin Lymphoma (HL)

• Definition: Hodgkin lymphoma, also known as Hodgkin’s disease, accounts for about 40% of childhood lymphomas. It is characterized by the presence of abnormal Reed-Sternberg cells, which are large, cancerous B cells. HL is more common in adolescents and young adults.
• Types:
• Classical Hodgkin Lymphoma (CHL): This is the most common type of Hodgkin lymphoma and includes several subtypes:
• Nodular Sclerosis Hodgkin Lymphoma (NSHL): The most common subtype of CHL, particularly in adolescents, is characterized by scar tissue (sclerosis) in the lymph nodes.
• Mixed Cellularity Hodgkin Lymphoma (MCHL): More common in younger children and associated with a mix of different cell types, including Reed-Sternberg cells.
• Lymphocyte-Rich Hodgkin Lymphoma (LRHL): A rarer form, with many normal lymphocytes and few Reed-Sternberg cells.
• Lymphocyte-Depleted Hodgkin Lymphoma (LDHL): The least common and most aggressive subtype, typically seen in older adults but rare in children.
• Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL): This rarer form of Hodgkin lymphoma occurs in children and has a better prognosis compared to classical forms. It involves large cells that resemble Reed-Sternberg cells but behave differently.
• Symptoms: Swollen lymph nodes (often painless) in the neck, armpits, or groin, fever, night sweats, weight loss, fatigue, and itching.
• Diagnosis: A biopsy of the lymph node is essential for diagnosing Hodgkin lymphoma. Other tests include blood tests, imaging (CT, PET scans), and bone marrow biopsy.
• Treatment: Treatment for HL often involves chemotherapy, radiation therapy, and in some cases, immunotherapy. The choice of treatment depends on the stage and subtype of the disease.
• Prognosis: Hodgkin lymphoma in children has a high cure rate, with long-term survival rates exceeding 90%, especially for early-stage disease. (Source)

2. Non-Hodgkin Lymphoma (NHL)

• Definition: Non-Hodgkin lymphoma is more common than Hodgkin lymphoma in children, accounting for about 60% of pediatric lymphoma cases. NHL in children tends to be more aggressive and fast-growing but is also highly treatable with prompt intervention.
• Types:
• Burkitt Lymphoma (BL): A highly aggressive form of NHL that originates in B lymphocytes. Burkitt lymphoma is one of the fastest-growing cancers and often affects the abdomen, leading to swelling and pain. It may also spread to the central nervous system and other organs.
• Diffuse Large B-Cell Lymphoma (DLBCL): Another aggressive form of NHL that starts in B lymphocytes. It can develop in lymph nodes or extranodal sites, such as the digestive tract or central nervous system.
• Lymphoblastic Lymphoma (LBL): Similar to acute lymphoblastic leukemia (ALL), this type of NHL primarily affects T lymphocytes, although it can also involve B cells. It typically develops in the thymus and spreads to other lymph nodes and organs.
• Anaplastic Large Cell Lymphoma (ALCL): A rare form of NHL that starts in T lymphocytes. It can present as either systemic (throughout the body) or as cutaneous lymphoma (affecting the skin). It may also involve lymph nodes and other organs.
• Symptoms: Symptoms of NHL can vary depending on the location of the tumor. Common symptoms include swollen lymph nodes, abdominal pain, breathing difficulties (if the tumor is in the chest), fever, weight loss, and night sweats.
• Diagnosis: Diagnosis is made through a biopsy of the tumor or lymph node, followed by imaging tests (CT, PET scans), blood tests, and bone marrow aspiration. In cases where the central nervous system is involved, a lumbar puncture may be necessary.
• Treatment: NHL in children is treated with chemotherapy, which may be intensive depending on the type and stage of the disease. Radiation therapy is used in specific cases, particularly when the tumor is localized. Targeted therapies and immunotherapy are also becoming increasingly available for certain subtypes of NHL.
• Prognosis: The prognosis for children with NHL is generally favorable, especially for Burkitt lymphoma and lymphoblastic lymphoma. The 5-year survival rate for NHL varies by subtype but typically ranges from 70-90%, with earlier diagnosis and treatment leading to better outcomes. (Source)

Symptoms of Lymphoma in Children

Symptoms of lymphoma in children can often be nonspecific, which can delay diagnosis. However, common symptoms to watch for include:

• Swollen lymph nodes: Often painless and found in the neck, armpit, or groin.
• Fever: Unexplained fever that does not respond to common treatments.
• Night sweats: Excessive sweating during sleep.
• Weight loss: Unexplained and rapid weight loss.
• Fatigue: Persistent tiredness despite adequate rest.
• Coughing or difficulty breathing: Especially if the lymphoma affects the chest.
• Abdominal pain or swelling: Common in cases of Burkitt lymphoma.
  (Source)

Diagnostic Procedures for Lymphoma

Diagnosing lymphoma in children involves several steps, including:

1. Physical Exam and Medical History: A thorough physical examination to check for swollen lymph nodes or other signs of lymphoma.
2. Biopsy: A biopsy is essential to confirm lymphoma. A sample of the lymph node or tumor is examined under a microscope to identify cancerous cells.
3. Imaging Tests: CT scans, PET scans, and MRI are used to detect the spread of lymphoma to other parts of the body.
4. Blood Tests: These help assess the overall health of the child and check for abnormal levels of certain cells.
5. Bone Marrow Aspiration and Biopsy: These tests help determine whether the lymphoma has spread to the bone marrow. (Source)

Treatment Options for Pediatric Lymphoma

1. Chemotherapy: Chemotherapy is the primary treatment for both Hodgkin and non-Hodgkin lymphoma. It involves using drugs to kill cancer cells throughout the body. The intensity and duration of chemotherapy depend on the type and stage of lymphoma.
2. Radiation Therapy: Radiation therapy is often used for Hodgkin lymphoma and some cases of NHL. It targets specific areas where the lymphoma is concentrated.
3. Immunotherapy: For certain subtypes of lymphoma, immunotherapy may be used. These treatments enhance the immune system’s ability to fight cancer.
4. Targeted Therapy: Targeted drugs specifically attack cancer cells without harming normal cells. This is becoming more common in the treatment of certain types of NHL.
5. Stem Cell Transplant: In high-risk or recurrent cases, a stem cell transplant may be recommended. This involves replacing damaged bone marrow with healthy stem cells to regenerate normal blood cells. (Source)

Prognosis and Survival Rates

The prognosis for children with lymphoma varies depending on several factors, including the type of lymphoma, the stage of the disease, and the child’s overall health:

• Hodgkin Lymphoma: The overall prognosis for children with Hodgkin lymphoma is excellent, with long-term survival rates of more than 90%, especially when diagnosed early.
• Non-Hodgkin Lymphoma: The prognosis for NHL in children is also favorable, with survival rates ranging from 70-90%, depending on the subtype and how early the disease is detected and treated.

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Conclusion

Lymphoma in children, while serious, is highly treatable with modern medical interventions. Hodgkin lymphoma and non-Hodgkin lymphoma are the two primary types, each with several subtypes that dictate treatment options and outcomes. With advancements in chemotherapy, radiation therapy, immunotherapy, and targeted treatments, the survival rates for pediatric lymphoma have improved dramatically over the years. Early diagnosis and prompt treatment are crucial for improving prognosis and long-term survival.