What is Childhood Non-Hodgkin’s Lymphoma? Non-Hodgkin's lymphoma is a type of cancer that occurs in the lymph system, which is part of the body's immune system. The other major type of lymphoma is Hodgkin's Lymphoma. Although lymphomas rarely occur in children, they are treated differently than in an adult patient, and therefore are described separately. Cancer occurs due the abnormal growth of cells within the lymph system. The lymph system is made up of thin tubes that branch, like blood vessels, into all parts of the body. Lymph vessels carry lymph, a colorless, watery fluid that contains white blood cells called lymphocytes. Along the network of vessels are groups of small, bean-shaped organs called lymph nodes. Clusters of lymph nodes are found in the underarm, pelvis, neck, chest, and abdomen. The lymph nodes make and store infection-fighting cells. The spleen (an organ in the upper abdomen that makes lymphocytes and filters old blood cells from the blood), the thymus ( a small organ beneath the breastbone), and the tonsils (lymph tissue in the throat) are also part of the lymph system. The primary difference between Hodgkin's disease and Non-Hodgkin's Lymphoma is the presence of a specific abnormal cell named Reed-Sternberg cells. Types of Childhood Non-Hodgkin’s Lymphoma There are three major types of childhood non-Hodgkin’s lymphoma: Lymphoblastic lymphoma: spreads quickly to the bone marrow, other lymph nodes, the surface of the brain, and membranes around the heart; accounts for less than one-third of cases Small non-cleaved cell lymphoma: 2 subtypes: Burkitt’s lymphoma ann non-Burkitt’s lymphoma; spreads very quickly to other organs including the surface and interior of the brain; accounts for about 40% of cases of non-Hodgkin’s lymphoma Large cell lymphoma: may develop in lymphoid tissue of the neck, the area near the thymus, throat or abdomen and early on it may spread to the skin or tissues under the skin; seldom spreads to the bone marrow or the brain. Risk Factors Weak immune system. Either as the result of a birth defect, genetic defect or from drugs used to treat other diseases, children who suffer from a weakened or altered immune system may have a higher risk of developing this disease. Radiation therapy. Children who have undergone radiation therapy may have a slightly higher risk of developing non-Hodgkin’s lymphoma later in life. Hodgkin’s Lymphoma. Children who have been treated with chemotherapy for Hodgkin’s lymphoma may have a higher risk of developing non-Hodgkin’s lymphoma 5-10 years later. However – the benefits of chemotherapy for this type of cancer far outweigh the risks. Transplant patients. Transplant patients are treated with drugs that suppress the immune system so they do not reject the new organ. A weakened immune system creates a greater risk of developing non-Hodgkin’s lymphoma. It is important to remember that most children with non-Hodgkin's lymphoma have no known risk factors. There is nothing these children or their parents could have done to prevent this cancer. Common Symptoms Shortness of breath Difficulty breathing Wheezing High-pitched breathing sounds Swelling of the head or neck Difficulty swallowing Painless swelling of the lymph nodes in the neck, underarm, stomach, or groin Fever Unexplained weight loss Night sweats These symptoms may be indicative of cancer or of other medical conditions. If your child is experiencing any of these symptoms, he/she should see his/her doctor. Diagnosing Childhood Non-Hodgkin’s Lymphoma If symptoms are present, your child’s doctor will perform a complete physical exam and may prescribe additional tests to find the cause of the symptoms. Tests may include: Thoracentesis Chest x-ray CT (or CAT) scan Biopsy If cancer is detected, additional tests will be performed to identify the type and [stage] (progress) of the disease. Treatment Options Once the diagnosis is confirmed, your child’s doctor will work with you and your child to determine the best plan of treatment. Treatment will depend upon the type of cancer, its stage, as well as your child’s age and general health. Current treatment options may include chemotherpay, radiation therapy and/or a blood and marrow transplant.