pediatric lymphoma | Pediatric Hodgkin's lymphoma

Pediatric Hodgkin's lymphoma

With new and improved treatments, the cancer survival rate in children has improved dramatically over the last few decades. Scientists continue to look for the causes of lymphoma in children in order to develop better treatments with lesser toxic side effects.

For information on how to deal with pediatric cancers, click here.
Click on the links below to learn more about pediatric Hodgkin's lymphoma.

Treatment
Survival and special health care needs
Follow-up care
Long-term effects and late effects of treatment
Current research
Treatment
Diagnosing a child's cancer can create a lot of uncertainty for parents and other family members. All of a sudden, the family is plunged into a whirlwind of change, anxiety and fear. Parents will have to make decisions about treatments while taking the time to comfort their child, in addition to coping with their own emotions.

The treatment of a child depends on a number of factors:

The stage of the disease
The subtype of the disease
Potential risk factors that may be revealed by laboratory tests
The rate of response to treatment as measured by medical imaging tests such as positron emission tomography and CT.
The child's hematology-oncologist (a cancer specialist) will establish a treatment plan that limits the amount of treatment needed to arrive at the remission. Parents should discuss side effects and potential long-term effects with the oncologist to determine the different treatment options.

Adults of childbearing age and parents of affected children should inform their doctor of choices that can reduce the risk of infertility.

Chemotherapy drug Associations
Children and young adults with Hodgkin's lymphoma are usually treated with chemotherapy combined with radiation from the affected area. The most recent progress in treatment is the ability of physicians to develop a treatment plan that limits the amount of therapy needed to elicit remission.

The most common combinations of chemotherapy drugs used to treat children and young adults include:

COPP: Cyclophosphamide (Cytoxan ®), Vincristine (Oncovin ®), prednisone, Procarbazine (Matula ®);
ABVD: Doxorubicin (Adriamycin ®), Bleomycin (Blenoxane ®), Vinblastine (Cytoxan ®), Dacarbazine (DTIC-Dome ®);
COPP-ABV: Cytoxan, Oncovin, prednisone, Matula, Adriamycin, Blenoxane, Cytoxan;
CHOP: Cytoxan, Hydroxydaunomycin, Oncovin, prednisone;
Stanford V: Mechlorethamine (Mustargen ®), Adriamycin, Cytoxan, Oncovin, Blenoxane, etoposide, prednisone.

Clinical trials
A clinical trial might be an option to consider when it comes to finding the appropriate treatment for your child's cancer, which will allow it to have access to new and improved treatments still under study and that are not yet on the market. Parents should discuss with their child's doctor the possibility of participating in a clinical trial, where treatment is administered under high surveillance in a safe environment.

Survival and special health care needs

After the treatment, most of the children will be able to live a rich and well-filled life. Many survivors return to school, go to university, find themselves in the labour market, get married and have children.

Parents might consider for their child a survival program that focuses on life after cancer. These programs are available in several major hospitals across the country.

Follow-up care

Your child will need to visit their pediatrician or doctor at least once a year for a complete physical examination and any additional examination necessary. Your oncologist should also examine your child regularly.

Regular medical visits are recommended:

To allow physicians to fully assess the effects of treatment

To detect and treat any recurrence of the disease

To identify and manage long-term effects and late effects of treatment.

Your child's pediatrician should recommend a schedule for evaluating his or her learning skills. If the child appears to have learning difficulties, special education methods could be identified.

Co-ordination between the pediatrician and the child's oncologist is important to ensure that it is in the best possible care. Some treatment centres offer comprehensive follow-up care clinics for juvenile cancer survivors.

Long-term effects and late effects of treatment

Some side effects of cancer treatment, such as fatigue, can persist for months or even years after the end of treatment. Some medical conditions such as heart disease and other cancers may only appear years after the end of treatment. Long-term effects and late effects can affect your child's physical, mental and cognitive health.

Most children who survive lymphoma will not have long-term effects or significant late effects as a result of treatment. However, some patients will have mild to severe effects.

Late effects and long-term effects of chemotherapy

Children treated for lymphoma may have a higher risk of the following effects:

Fatigue

Growth delays

thyroid dysfunction

Hearing Loss

Secondary Cancer

Some late effects and long-term effects are manifested with maturation (puberty), growth and the normal aging process. Early interventions and healthy life practices (abstaining from smoking, good nutrition, exercise, regular screening and follow-up) can help.

Late effects and long-term effects of radiation therapy

Girls and women under the age of 30 who have received chest radiotherapy are at risk of developing breast cancer 15 to 20 years after treatment. Survivors of pediatric male cancers are at risk of developing secondary cancers but do not have as high a risk of breast cancer as the survivors.

Girls who have received a chest radiotherapy treatment (X-ray mediastinal) should:

Conduct monthly breast self-examination;

Have a reference mammography when they are between 25 and 30 years or 10 years after radiotherapy;

Have a clinical examination of the annual breasts;

Have a mammogram for two or three years, depending on the density of the breast tissue.

Both boys and girls receiving mediastinal radiation therapy should have a baseline examination of cardiac function that should be followed by a three-to five-year examination after treatment and more frequently if an anomaly is detected.

Back to Class

Learning disabilities may occur during the course of treatment or in the months or years that follow. It is important to inform family members, friends, school staff and health care professionals about the long-term effects and possible late effects of your child's treatment. Discuss your child's needs with teachers before returning to class. Work with your child's teachers and health professionals to develop a program tailored to their needs that includes a baseline test, accommodations, and long-term planning.

Click here to learn more about the return of children with cancer to the classroom.

Current research

Researchers are working to broaden their understanding of long-term effects and late effects to create guidelines for follow-up care. These researchers are also trying to understand how factors such as ageing and social and economic status influence these effects.