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About Cancer > Lymphoma

Lymphoma

Lymphoma is a type of blood cancer that affects the lymphatic system. There are two types of lymphoma – Non-Hodgkin (NHL) and Hodgkin (HL), each requiring different treatment.

How Does Lymphoma Form?

The lymphatic system is part of your immune system and is made up of bone marrow, thymus, spleen and lymph nodes. Lymphomas can affect any part of the lymphatic system including the neck, above the collarbone, armpit, groin or chest 3The lymphatic system is linked by lymphatic vessels. Through these infection-fighting white blood cells known as lymphocytes flow. In lymphoma, these cells begin to multiply abnormally and collect in the lymphatic system. Because the lymphocytes are abnormal, they lose their ability to fight infection, making the child more susceptible to infections.

The classification of lymphoma is done once a biopsy has been taken. In Hodgkin Lymphoma, abnormal cells, known as Reed-Sternberg cells, are present when the biopsy is analysed under a microscope

Symptoms of Hodgkin and non-Hodgkin lymphoma

The symptoms of both types of lymphoma are similar and most commonly include a swelling in the neck, armpit or groin. Usually painless the swellings are caused by a build-up of lymphocytes in the affected lymph node. Other symptoms may include night sweats, unintentional weight loss, high temperature, persistent cough or persistent itching.

Incidence of Lymphoma

The number of children in England diagnosed with Lymphoma between 2003 and 2012 was 1513, accounting for 35% of cancers diagnosed in that period. 2

Hodgkin Lymphoma (HL)

In Hodgkin Lymphoma, abnormal cells known as Reed-Sternberg cells are present when a biopsy is taken. There are two main types of Hodgkin lymphoma, Classical lymphoma affecting around 95% of patients and Lymphocyte Predominant Hodgkin Lymphoma (LPHL) affecting just 5%

Staging of Hodgkin Lymphoma

Hodgkin Lymphoma is given both a stage and a letter to describe the size and position of the cancer, as well as the symptoms being shown by the patient. The stage and the letter given to the lymphoma will ultimately define the treatment plan.

Stages include:

Stage 1 – only one group of lymph nodes is affected and the lymphoma is only on one side of the diaphragm (the sheet of muscle under the lungs that controls breathing)

Stage 2 – two or more groups of lymph nodes are affected, but they are only on one side of the diaphragm.

Stage 3 – the lymphoma is in lymph nodes both above and below the diaphragm.

Stage 4 – the lymphoma has spread outside the lymph nodes to other organs such as the liver, lungs or bone marrow.

As well as giving each stage a number, doctors also use a letter code – either A, B, or E:

A – Means your child has no symptoms.

B – Means your child has one or more of the following symptoms: a fever, night sweats or significant weight loss.

E – Means that the lymphoma has grown from the lymph gland to extra nodal tissue (tissue in places outside the lymph nodes).

Incidence & Causes of Hodgkin Lymphoma

The exact cause of Hodgkin Lymphoma is not known. However, there is some evidence to suggest that infections such as glandular fever can increase the risk of childhood lymphoma. (NHS, 2016)
The number of children in England Diagnosed between 2003 and 2012 was 620, accounting for 41% of lymphomas diagnosed in that period.<a href=”http://www.ncin.org.uk/cancer_type_and_topic_specific_work/cancer_type_specific_work/cancer_in_children_teenagers_and_young_adults/”>2</a>

Treatments For Hodgkin Lymphoma

Treatment will ultimately depend on the staging and the letter assigned to the cancer, however chemotherapy is usually used. Sometimes radiotherapy is required3

Outlook / Survival For Hodgkin Lymphoma

The statistics below are based on the five year survival rate for children who were diagnosed under the age of 15 in England.
For those diagnosed in 2008-2012 the survival rate was 97%, an increase of 3% for those diagnosed in 2003-2007 signalling an improvement in the effectiveness of treatments
.2
Although free of cancer, approximately 60% of childhood cancer survivors will suffer from a “late-effect” caused by the treatments used to save their lives4

Non-Hodgkin Lymphoma (NHL)

In Non-Hodgkin Lymphoma, abnormal cells known as Reed-Sternberg cells are not present when a biopsy is taken. There are two main types of NHL – B-cell NHL usually affecting the lymph nodes in the abdomen, intestines and potentially the head and neck, and T-cell NHL affecting lymph nodes in the chest.

Staging of Non-Hodgkin Lymphoma

Non-Hodgkin Lymphoma is given a stage to describe the size and position of the cancer, which will ultimately define the treatment plan. The stages are:

Stage 1 – one group of lymph nodes is affected, or there’s a single extranodal cancer.

Stage 2 – two or more groups of nodes are affected, or there is a single extranodal cancer that has spread to nearby lymph nodes; or there are two single extranodal cancers, but only on one side of the diaphragm (the sheet of muscle under the lungs, which plays a large part in our breathing).

Stage 3 – there is lymphoma on both sides of the diaphragm (either in two or more groups of nodes) or there are two single extranodal cancers or the lymphoma is affecting the chest.

Stage 4 – the lymphoma has spread beyond the lymph nodes to other organs of the body such as the bone marrow or nervous system.


Incidence & Causes of Non-Hodgkin Lymphoma

The exact cause of Non-Hodgkin Lymphoma is not known3. The number of children in England Diagnosed between 2003 and 2012 was 776, accounting for 51% of lymphomas diagnosed in that period2


Treatments

Treatment will ultimately depend on the staging of the lymphoma; however, chemotherapy is usually used. In B-cell NHL, chemotherapy is usually given in 4-8 intense courses where T-Cell is less intensive but will last longer – possibly 2-3 years. Sometimes radiotherapy or a bone marrow transplant is required.


Outlook / Survival

The below is based on the five year survival rate for children who were diagnosed under the age of 15 in England. For those diagnosed in 2008-2012 the survival rate was 89%, an increase of 5% for those diagnosed in 2003-2007, signalling an improvement in the effectiveness of treatments. 2

Although free of cancer, approximately 60% of childhood cancer survivors will suffer from a “late-effects” caused by the treatments used to save their lives 4


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