Childhood lymphoma treatment

How is childhood lymphoma treated?

Treatment varies depending on the exact type of lymphoma your child has, where it has spread in their body and how fast it is likely to grow. Their age and their general health are also taken into account.

In helping you to make the best treatment decision, your child’s doctor will consider all the information available including information gathered from hundreds of other people around the world who have had lymphoma and the details of your child’s particular situation.

Treatment for lymphoma usually involves chemotherapy or radiotherapy and surgery. Peripheral blood stem cell transplantation can be used when the lymphoma has come back (relapsed) or is at high risk of relapse, and where it doesn’t respond well to standard (conventional) treatment.

Chemotherapy

Chemotherapy literally means therapy with chemicals. Many chemotherapy drugs are also called cytotoxics (cell toxic) because they kill cells, especially ones that multiply quickly like cancer cells.

Chemotherapy is given as a combination of drugs, in several cycles (or courses) of treatment with a rest period of a few weeks in between each cycle. A typical chemotherapy regime for lymphoma might involve around six cycles of a combination of drugs, given over a period of six months.

There are many different ways of giving chemotherapy. It may be given through a vein (intravenously or IV), usually in your child’s arm or hand, or in tablet or liquid form (orally). Your child’s doctor may recommend that your child have a central venous catheter (also called a central line) inserted.

Once in place, chemotherapy and any other IV drugs can be given through the line and blood tests can usually be taken from the line. There are several different kinds of central lines used; some are intended for short-term use while others remain in place for months and even years.

Length of treatment cycles is dependent on the type of lymphoma your child has and their response to treatment. Those with low-stage lymphoma are generally treated with a less intensive combination of chemotherapy drugs. Children with high-stage disease are treated with more intensive chemotherapy.

Hodgkin and B-cell lymphomas are generally treated over a few months to a year while treatment for T-cell lymphoma can be around two years. If lymphoma cells have been found in your child’s brain or spinal column, intrathecal chemotherapy will be given. This is chemotherapy injected directly into the spinal fluid via a needle in a procedure called a lumbar puncture. A light anaesthetic or mild sedation is given to your child for this treatment.

Radiotherapy

Radiotherapy is a form of local therapy, because it only destroys cancer cells in the treated area (radiation field). It is commonly used to treat disease that is confined to one area of the body. Radiotherapy uses high energy x-rays to kill cancer cells and shrink cancers.

Radiotherapy is usually given in small doses (also known as fractions) each weekday (Monday to Friday) over a few weeks in the radiotherapy department of the hospital.  Your child does not see or feel anything during the actual radiotherapy treatment. Radiotherapy can be conducted as an outpatient.

Before radiotherapy begins, the radiotherapist (doctor who specialises in treating people with radiotherapy) will carefully calculate the correct dose of radiation therapy for your child. The areas of their body that need to be treated will be marked with tiny ink dots on their skin using a special pen. Radiotherapy is usually given in small doses (also known as fractions) each week day (Monday to Friday) over a few weeks in the radiotherapy department of the hospital.

When your child is having radiotherapy they will usually lie on a table underneath the radiotherapy machine which delivers the planned dose of radiation. Important structures like their heart and lungs are shielded as much as possible to ensure that they are not affected by the treatment given. Radiotherapy is painless. In fact your child will not see or feel anything during the actual treatment. They will however need to stay perfectly still for a few minutes while the treatment is taking place.

Prognosis

It is important to remember that the prognosis for children with lymphoma is generally good and the majority recover completely.

Your treating specialist is the best person to discuss your child’s prognosis and treatment options with as your child’s recovery is dependent on what type of lymphoma they have, the extent of their disease and any previous medical history.