Childhood Hodgkin's Lymphoma : Treatment Options

by National Cancer Institute

(Page 3 of 3)

There are different types of treatment for children with Hodgkin's lymphoma.

Different types of treatment are available for children with Hodgkin's lymphoma. Some treatments are standard and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Because cancer in children is rare, taking part in a clinical trial should be considered. Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Children with Hodgkin's lymphoma should have their treatment planned by a team of doctors with expertise in treating childhood cancer.

Your child's treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist may refer you to other pediatric doctors who have experience and expertise in treating children with Hodgkin's lymphoma and who specialize in certain areas of medicine. These may include the following specialists:

• Medical oncologist/hematologist.
• Pediatric surgeon.
• Radiation oncologist.
• Endocrinologist.
• Pediatric nurse specialist.
• Rehabilitation specialist.
• Psychologist.
• Social worker.

Two types of standard treatment are used:

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. Combination chemotherapy is treatment using more than one anticancer drug. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Other types of treatment are being tested in clinical trials. These include the following:

High-dose chemotherapy with stem cell transplant

High-dose chemotherapy with stem cell transplant is a method of replacing blood-forming cells destroyed by high doses of anticancer drugs or radiation therapy. Stem cells (immature blood cells) are removed from the bone marrow or blood of the patient or a donor and are frozen and stored. After therapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Surgery

Surgery may be done to remove as much of the tumor as possible.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options for Children and Adolescents with Hodgkin's Lymphoma

Low-Risk Childhood Hodgkin's Lymphoma

Treatment of low-risk childhood Hodgkin's lymphoma may include the following:

• Combination chemotherapy with low-dose radiation therapy to involved areas.
• A clinical trial of combination chemotherapy with or without low-dose radiation therapy to involved areas.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Intermediate-Risk Childhood Hodgkin's Lymphoma

Treatment of intermediate-risk childhood Hodgkin's lymphoma may include the following:

• Combination chemotherapy with low-dose radiation therapy to involved areas.
• A clinical trial of combination chemotherapy with or without low-dose radiation therapy to involved areas.
• A clinical trial of new combinations of chemotherapy before low-dose radiation therapy to involved areas.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

High-Risk Childhood Hodgkin's Lymphoma

Treatment of high-risk childhood Hodgkin's lymphoma may include intensive or high-dose combination chemotherapy with low-dose radiation therapy to involved areas.

Nodular Lymphocyte Predominant Childhood Hodgkin's Lymphoma

Treatment of nodular lymphocyte predominant childhood Hodgkin's lymphoma may include the following:

• Combination chemotherapy with low-dose radiation therapy to involved areas.
• A clinical trial of surgery only, when the lymphoma is stage I and no cancer remains after the surgery.
• A clinical trial of combination chemotherapy with or without low-dose radiation therapy to involved areas for patients with stage I or stage II.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options for Primary Progressive/Recurrent Hodgkin's Lymphoma in Children and Adolescents

Treatment of primary progressive or recurrent childhood Hodgkin's lymphoma may include the following:

Chemotherapy with low-dose radiation therapy to involved areas for stage I or stage II non-bulky disease. Adolescent patients who have reached full growth may be treated with standard-dose radiation therapy.

High-dose chemotherapy with stem cell transplant with or without radiation therapy.

Late Effects from Childhood and Adolescent Hodgkin's Lymphoma Treatment

Children and adolescents may have treatment-related side effects that appear months or years after treatment for Hodgkin's lymphoma. Because of these late effects on health and development, regular follow-up exams are important. Late effects may include problems with the following:

• Development of sex organs in males.
• Fertility (ability to have children).
• Thyroid, heart, or lungs.
• An increased risk of developing a second primary cancer.
• Bone growth and development.

The risk of these long-term side effects will be considered when treatment decisions are made.

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