Lymphoma in Children – Causes, Diagnosis, and Treatment

As a parent, it is normal to be concerned about the health and well-being of your child. Anything happens to your child and you start worrying. You don’t want any harm to come to him, but that is not something you can control. There are many fatal conditions that may affect the health of a child, and one such condition is lymphoma. Know what exactly lymphoma is, what causes it and how to treat it.

What Is Lymphoma?

Before we discuss lymphoma, it is important to understand the lymphatic system. The lymphatic system is a part of the vascular system consisting of lymph vessels, nodes, ducts, and tissues. The lymphatic vessels carry a clear fluid known as lymph towards the heart. This fluid consists of infection-fighting white blood cells that include lymphocytes too. The lymphocytes are concentrated in the lymph system, which comprises of tonsils, bone marrow, spleen thymus, and lymph nodes (small organs in the chest, abdomen, groin, neck, and underarms).

The condition known as lymphoma occurs when lymphocytes multiply uncontrollably. This cause the enlargement of the lymph nodes that may infect other parts of the body too, including the nervous system and the bone marrow.

Types of Lymphoma

Lymphoma is further classified into two types:

1. Hodgkin’s Lymphoma

This is a kind of cancer that occurs due to Reed-Sternberg cells. The cancer is further classified into various categories according to the severity of the condition and on the appearance of cells under the microscope. This cancer may usually affect children in their adolescent years. Though there are no specific reasons that may establish the onset of this fatal condition, it is believed that in almost 50 percent of the cases it may result from the Epstein-Barr virus or EBV.

2. Non-Hodgkin’s Lymphoma (NHL)

This kind of cancer may affect children of any age group, however, it is rarely registered in kids who are less than three years. This involves the malignant growth of special kinds of cells in the lymph nodes. This may further be classified into:

• A high-grade tumour

This includes lymphoblastic lymphoma, Burkett lymphoma, and non-Burkett lymphoma.

• An intermediate-grade tumour

This may include various kinds of tumours such as mantle cell lymphoma, follicular large-cell lymphoma, anaplastic Ki-1 large-cell lymphoma (CD30+), immunoblastic diffuse large cell lymphoma, and peripheral T-cell lymphoma.

What Causes Lymphoma in Kids?

Like most cancers, lymphoma is not contagious. It may affect children who have a weak immune system. Also, it is observed that lymphoma may not run in families, but there have been cases where genetics were involved, though these cases were extremely rare and it does not mean that the family members will have to get a screening done for cancer.

There are no known causes of lymphoma in children but there are many studies that are still going on to establish the real cause of this disease.

Risk Factors of Lymphoma in Children

The risk of lymphoma in children may increase under the following circumstances:

1. Hodgkin’s Lymphoma

• If your kid is on a medication that suppresses his immune system, then he might be susceptible to Hodgkin’s lymphoma. If your kid has undergone an organ transplant and is on medication that affects his immune system, then he may get it.
• If your child is born with a problem in his immune system such as ataxia telangiectasia, which is a genetic condition, he may get Hodgkin’s lymphoma.
• If your kid is infected with HIV or human immunodeficiency syndrome, it may increase his chances of having Hodgkin’s Lymphoma.

2. Non-Hodgkin’s Lymphoma

• If your child has AIDS or acquired immunodeficiency syndrome, it may lead to Non-Hodgkin’s Lymphoma.
• If your kid has undergone an organ transplant.
• If your child was born with problems with his immune system.
• If your child has undergone treatment for some other kind of cancer.

Signs and Symptoms of Lymphoma

The most evident symptom of lymphoma is swollen lymph nodes or swollen lymph nodes on one side of a child’s neck, which may also be visible around the underarm, groin, and neck. These are usually painless. But there are many other symptoms of lymphoma in children, which are as follows:

• Breathing difficulty and
• Unexplained fever
• Weight loss and loss of appetite
• Swelling in the abdominal region
• Night Sweats

How Is Lymphoma Diagnosed?

Here are some of the methods that your doctor may adopt to determine the symptoms of lymphoma in your child:

1. Physical Examination

Your doctor may examine your kid’s enlarged lymph nodes.

2. Blood Tests

Blood tests are done to check the blood count and to see if there are any conditions such as anaemia or low blood cells.

3. X-ray

This may be conducted to have a more comprehensive look inside the various structures inside the body.

4. MRI

This may be advised to see the detailed images of the enlarged lymph nodes.

5. Biopsy

This may be suggested to test the tissue from the enlarged gland.

6. CT scan

This involves taking three-dimensional pictures of the inside of the body to check for any tumours or other such abnormalities.

7. PET or PET-CT scan

This involves inserting radioactive sugar substance to produce more comprehensive images to detect any kind of abnormalities and tumours.

8. Bone Marrow Biopsy

This is an advanced stage test that requires testing tissue from the bone marrow.

Stages of Lymphoma in Children

Following are the different stages of lymphoma in children:

1. Stage 1

In the first stage cancer affects only one area of the lymph nodes.

2. Stage 2

In this stage, cancer affects one area and may start affecting two or more lymph nodes.

3. Stage 3

In this stage, cancer is present in the lymph nodes, below and above the diaphragm, in the chest, in the abdomen and sometimes in the spleen, too.

4. Stage 4

In the last stage, cancer spreads to the other parts of the body such as the liver, lungs, bones, brain etc.

Treatments Available for Lymphoma in Children

Here are some treatment options available for lymphoma:

1. Chemotherapy

One of the preferred options for the treatment of lymphoma is chemotherapy, which may help in stopping the growth of abnormal white blood cells and kill the lymphoma cells.

2. Radiation Therapy

If your kid responds well to chemotherapy, radiation may not be required. However, if your doctor feels the need, he may recommend radiation therapy along with chemotherapy.

3. Other Innovative Strategies

This may include medications that may directly target the tumours.

Side Effects of Lymphoma in a Child

Lymphoma may affect your child in more than one way, and following are some side effects that you may notice:

• Chemotherapy may cause bleeding problems, increase the risk of infections, and even affect the bone marrow.
• Short-term effects of lymphoma in children include a change of skin colour, loss of hair, nausea, etc.
• Long-term effects may include thyroid problems, reproductive problems, heart and kidney damage etc.

Chances of Recurrence of Lymphoma in Kids

In most cases of lymphoma, children recover and there are no relapses. However, if your kid has a serious case of lymphoma, then there are chances of reoccurrence.

Other Treatment Options Available After Recurrence of Lymphoma in Children

If there are relapses or recurrence of lymphoma in children, your doctor may recommend stem cell transplants and bone marrow transplants. Other than that there are other treatments available such as immune therapy, special kinds of medicines that deliver chemotherapy medicines etc.

If you register any symptoms of lymphoma in your child, it is suggested that you seek immediate medical assistance for the same. Timely medical intervention and treatment may help your child recover better and faster and may even prevent the infection from spreading.