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CHILDHOOD HODGKIN LYMPHOMA

(HODGKIN DISEASE, NODULAR SCLEROSIS)
Childhood Hodgkin Lymphoma

WHAT YOU NEED TO KNOW:

What is Hodgkin lymphoma? Hodgkin lymphoma, or Hodgkin disease, is a cancer of the lymphatic system. The lymphatic system contains lymph vessels, lymph nodes, and glands. Lymph vessels carry lymph fluid throughout the body. Lymph fluid contains lymphocytes (white blood cells) that help fight infection and disease. Hodgkin lymphoma causes lymphocytes to grow and divide without control and to form tumors. Hodgkin lymphoma can develop in any lymph tissue in the body. Common places are lymph nodes in the neck, underarm, and chest. Hodgkin cancer cells can travel from lymph node to lymph node and spread through the body.

What increases my child's risk for Hodgkin lymphoma? Hodgkin lymphoma usually develops in the teens or 20s. It is less common in young children. The following may increase your child's risk at any age:

  • A family history of Hodgkin lymphoma

  • An infection such as Epstein-Barr virus (EBV), mononucleosis (mono), or HIV

  • Chemotherapy or radiation as a child increases his risk later in life

What are the signs and symptoms of childhood Hodgkin lymphoma?

  • Swollen lymph nodes in your child's neck, chest, underarm, or groin



  • Fever, night sweats, or itchy skin

  • Weight loss you cannot explain, loss of appetite, or fatigue

  • A cough, trouble breathing, or chest pain

How is childhood Hodgkin lymphoma diagnosed? Your child's healthcare provider will ask about your child's symptoms and when they began. Tell him if your child ever had an infection such as EBV. Tell him if your child has a family history of lymphoma or other cancers. The following tests may be used to diagnose Hodgkin lymphoma or to find out if it is early stage or later stage:

  • Blood tests may show abnormal white blood cells or signs of anemia (not enough red blood cells). The tests may also be used to measure the amount of inflammation in your child's blood. Blood tests can also be used to check his liver and kidney function, or see if the cancer has spread to bone.

  • A biopsy is a procedure to remove a sample of lymph node or bone marrow to be tested. Bone marrow is tissue inside the bone. Your child's healthcare provider may test a bone marrow sample to see if the cancer has spread to bone. He may use a needle to take a sample from a lymph node, or remove a lymph node during surgery. He will also check biopsy samples for certain cells. These cells help your healthcare provider know your child has Hodgkin lymphoma.

  • X-ray, CT, MRI, or PET scan pictures may be taken of your child's chest, abdomen, and pelvis. The pictures may show where the cancer is located. His healthcare provider may use the x-rays to look for tumors, blockages, signs of infection, or other problems. Your child may be given contrast liquid to help his healthcare provider see the cancer better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.

How is childhood Hodgkin lymphoma treated? Treatment will depend on your child's age and development. Treatment will also depend on the size and location of any tumors. Your child's healthcare provider will talk to you about the following treatments. The type of Hodgkin lymphoma your child has may also factor into the treatment decision.

  • Chemotherapy is medicine used to treat cancer by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that contain cancer.

  • Radiation therapy uses x-rays or gamma rays to treat cancer. Radiation kills cancer cells and may stop the cancer from spreading. It may be given alone or with chemotherapy.

  • A bone marrow transplant is a procedure to replace your child's diseased bone marrow with healthy marrow. Bone marrow is usually given from a donor. Your child's own marrow may be used if it is collected when his cancer is in remission (not active). The bone marrow transplant will be given in an IV while your child is in the hospital.

  • Surgery may be used for some types of childhood Hodgkin lymphoma. Your child's healthcare provider will remove some or all of any affected lymph nodes during surgery.

What can I do to care for my child?

  • Have your child rest as needed. Your child should return to activities slowly, and do more as he feels stronger.

  • Offer your child a variety of healthy foods. Healthy foods will help your child get the protein, carbohydrates, and other nutrients his body needs. You may need to change the foods your child eats depending on his treatments and side effects. He may also need to eat more calories than usual. Work with a dietitian to plan the best meals and snacks for your child. Ask if he should take vitamins.

  • Keep your child away from people who have a cold or the flu. Also try to keep him away from large groups of people to decrease his risk.

  • Talk to your older child about not smoking. Talk to your healthcare provider if your child needs help quitting. E-cigarettes or smokeless tobacco still contain nicotine. Ask your child's healthcare provider for information before your child uses these products.

When should I seek immediate care?

  • Your child has sudden chest pain.

  • Your child has trouble breathing.

When should I contact my child's healthcare provider?

  • Your child has a fever.

  • A new lump develops in your child's body.

  • Your child's bones or muscles hurt.

  • Your child is vomiting and cannot keep any food or liquids down.

  • You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.