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Childhood Non-Hodgkin Lymphoma Treatment (PDQ®)

Patient Version
Last Modified: 02/10/2012

Treatment Options for Childhood Non-Hodgkin Lymphoma

Low-stage Childhood Non-Hodgkin Lymphoma
High-stage Childhood B-cell Non-Hodgkin Lymphoma
High-stage Childhood Lymphoblastic Lymphoma
High-stage Childhood Anaplastic Large-cell Lymphoma
Recurrent Childhood Non-Hodgkin Lymphoma
Lymphoproliferative Disease Associated with a Weakened Immune System

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Low-stage Childhood Non-Hodgkin Lymphoma

Treatment of low-stage (stage I or II) non-Hodgkin lymphoma in children and adolescents may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I childhood large cell lymphoma 1, stage I childhood small noncleaved cell lymphoma 2, stage I childhood lymphoblastic lymphoma 3, stage I childhood anaplastic large cell lymphoma 4, stage II childhood large cell lymphoma 5, stage II childhood small noncleaved cell lymphoma 6, stage II childhood lymphoblastic lymphoma 7 and stage II childhood anaplastic large cell lymphoma 8. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 9.

High-stage Childhood B-cell Non-Hodgkin Lymphoma

Treatment for high-stage (stage III or IV) B-cell (Burkitt and Burkitt-like) non-Hodgkin lymphoma in children and adolescents may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III childhood large cell lymphoma 10, stage III childhood small noncleaved cell lymphoma 11, stage IV childhood large cell lymphoma 12 and stage IV childhood small noncleaved cell lymphoma 13. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 9.

High-stage Childhood Lymphoblastic Lymphoma

Treatment of high-stage (stage III or IV) lymphoblastic lymphoma in children and adolescents may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III childhood lymphoblastic lymphoma 14 and stage IV childhood lymphoblastic lymphoma 15. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 9.

High-stage Childhood Anaplastic Large-cell Lymphoma

Treatment of high-stage (stage III or IV) anaplastic large-cell lymphoma in children and adolescents may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III childhood anaplastic large cell lymphoma 16 and stage IV childhood anaplastic large cell lymphoma 17. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 9.

Recurrent Childhood Non-Hodgkin Lymphoma

There is no standard treatment for patients with recurrent childhood non-Hodgkin lymphoma.

All patients with recurrent childhood non-Hodgkin lymphoma should be considered for clinical trials of new treatments.

Burkitt lymphoma and diffuse large B-cell lymphoma

Treatment options for recurrent Burkitt lymphoma and diffuse large B-cell lymphoma include:

Lymphoblastic lymphoma

Treatment options for recurrent lymphoblastic lymphoma include:

  • Combination chemotherapy.
  • High-dose chemotherapy with stem cell transplant.

Anaplastic large-cell lymphoma

Treatment options for recurrent anaplastic large cell lymphoma include:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood non-Hodgkin lymphoma 18. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 9.

Lymphoproliferative Disease Associated with a Weakened Immune System

Treatment of lymphoproliferative disease in children and adolescents with weakened immune systems may include the following:



Glossary Terms

anaplastic large cell lymphoma (A-nuh-PLAS-tik larj sel lim-FOH-muh)
An aggressive (fast-growing) type of non-Hodgkin lymphoma that is usually of the T-cell type. The cancer cells express a marker called CD30 or Ki-1 on the surface, and may appear in the lymph nodes, skin, bones, soft tissues, lungs, or liver. Also called ALCL.
B-cell lymphoma (…lim-FOH-muh)
A type of cancer that forms in B cells (a type of immune system cell). B-cell lymphomas usually occur in adults and may be either indolent (slow-growing) or aggressive (fast-growing). There are many different types of B-cell lymphomas, and prognosis and treatment depend on the type and stage of cancer.
Burkitt lymphoma (BER-kit lim-FOH-muh)
An aggressive (fast-growing) type of B-cell non-Hodgkin lymphoma that occurs most often in children and young adults. The disease may affect the jaw, central nervous system, bowel, kidneys, ovaries, or other organs. There are three main types of Burkitt lymphoma (sporadic, endemic, and immunodeficiency related). Sporadic Burkitt lymphoma occurs throughout the world, and endemic Burkitt lymphoma occurs in Africa. Immunodeficiency-related Burkitt lymphoma is most often seen in AIDS patients.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
combination chemotherapy (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee)
Treatment using more than one anticancer drug.
diffuse large B-cell lymphoma (dih-FYOOS larj ... sel lim-FOH-muh)
A type of B-cell non-Hodgkin lymphoma (cancer of the immune system) that is usually aggressive (fast-growing). It is the most common type of non-Hodgkin lymphoma, and is marked by rapidly growing tumors in the lymph nodes, spleen, liver, bone marrow, or other organs. Other symptoms include fever, night sweats, and weight loss. There are several subtypes of diffuse large B-cell lymphoma.
donor lymphocyte infusion (DOH-ner LIM-foh-site in-FYOO-zhun)
A type of therapy in which lymphocytes from the blood of a donor are given to a patient who has already received a stem cell transplant from the same donor. The donor lymphocytes may kill remaining cancer cells. Donor lymphocyte infusion is used to treat chronic myelogenous leukemia (CML) that has come back and myeloma. It is being studied in the treatment of other types of cancer.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
high-dose chemotherapy (hy-dose kee-moh-THAYR-uh-pee)
An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.
immune system (ih-MYOON SIS-tem)
The complex group of organs and cells that defends the body against infections and other diseases.
infusion (in-FYOO-zhun)
A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion.
intrathecal chemotherapy (IN-truh-THEE-kul KEE-moh-THAYR-uh-pee)
Treatment in which anticancer drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.
lymphoblastic lymphoma (LIM-foh-BLAS-tik lim-FOH-muh)
An aggressive (fast-growing) type of non-Hodgkin lymphoma in which too many lymphoblasts (immature white blood cells) are found in the lymph nodes and the thymus gland. These lymphoblasts may spread to other places in the body. It is most common in teenagers and young adults and affects more males than females. It may be a T or B cell type. Also called precursor lymphoblastic lymphoma.
lymphocyte (LIM-foh-site)
A type of immune cell that is made in the bone marrow and is found in the blood and in lymph tissue. The two main types of lymphocytes are B lymphocytes and T lymphocytes. B lymphocytes make antibodies, and T lymphocytes help kill tumor cells and help control immune responses. A lymphocyte is a type of white blood cell.
lymphoproliferative disorder (LIM-foh-proh-LIH-feh-ruh-tiv dis-OR-der)
A disease in which cells of the lymphatic system grow excessively. Lymphoproliferative disorders are often treated like cancer.
monoclonal antibody (MAH-noh-KLOH-nul AN-tee-BAH-dee)
A type of protein made in the laboratory that can bind to substances in the body, including tumor cells. There are many kinds of monoclonal antibodies. Each monoclonal antibody is made to find one substance. Monoclonal antibodies are being used to treat some types of cancer and are being studied in the treatment of other types. They can be used alone or to carry drugs, toxins, or radioactive materials directly to a tumor.
non-Hodgkin lymphoma (non-HOJ-kin lim-FOH-muh)
Any of a large group of cancers of lymphocytes (white blood cells). Non-Hodgkin lymphomas can occur at any age and are often marked by lymph nodes that are larger than normal, fever, and weight loss. There are many different types of non-Hodgkin lymphoma. These types can be divided into aggressive (fast-growing) and indolent (slow-growing) types, and they can be formed from either B-cells or T-cells. B-cell non-Hodgkin lymphomas include Burkitt lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), diffuse large B-cell lymphoma, follicular lymphoma, immunoblastic large cell lymphoma, precursor B-lymphoblastic lymphoma, and mantle cell lymphoma. T-cell non-Hodgkin lymphomas include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. Lymphomas that occur after bone marrow or stem cell transplantation are usually B-cell non-Hodgkin lymphomas. Prognosis and treatment depend on the stage and type of disease. Also called NHL.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
recurrent cancer (ree-KER-ent KAN-ser)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.
spinal cord (SPY-nul kord)
A column of nerve tissue that runs from the base of the skull down the back. It is surrounded by three protective membranes, and is enclosed within the vertebrae (back bones). The spinal cord and the brain make up the central nervous system, and spinal cord nerves carry most messages between the brain and the rest of the body.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stage I childhood non-Hodgkin lymphoma (... non-HOJ-kin lim-FOH-muh)
Cancer is found (1) in one group of lymph nodes; or (2) in one area outside the lymph nodes. No cancer is found in the abdomen or mediastinum (area between the lungs).
stage II childhood non-Hodgkin lymphoma (... non-HOJ-kin lim-FOH-muh)
Cancer is found (1) in one area outside the lymph nodes and in nearby lymph nodes; or (2) in two or more areas above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen), and may or may not have spread to nearby lymph nodes; or (3) to have started in the stomach or intestines and can be completely removed by surgery. Cancer may or may not have spread to certain nearby lymph nodes.
stage III childhood non-Hodgkin lymphoma (... non-HOJ-kin lim-FOH-muh)
Cancer is found (1) in at least one area above the diaphragm (the thin muscle below the lungs that helps with breathing and separates the chest from the abdomen) and in at least one area below the diaphragm; or (2) to have started in the chest; or (3) to have started in the abdomen and spread throughout the abdomen, and cannot be completely removed by surgery; or (4) in the area around the spine.
stage IV childhood non-Hodgkin lymphoma (... non-HOJ-kin lim-FOH-muh)
Cancer is found in the bone marrow, brain, or cerebrospinal fluid. Cancer may also be found in other parts of the body.
standard therapy (... THAYR-uh-pee)
Treatment that experts agree is appropriate, accepted, and widely used. Also called best practice, standard medical care, and standard of care.
stem cell transplant (stem sel tranz-plant)
A method of replacing immature blood-forming cells in the bone marrow that have been destroyed by drugs, radiation, or disease. Stem cells are injected into the patient and make healthy blood cells. A stem cell transplant may be autologous (using a patient’s own stem cells that were saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
systemic chemotherapy (sis-TEH-mik KEE-moh-THAYR-uh-pee)
Treatment with anticancer drugs that travel through the blood to cells all over the body.
T cell (... sel)
A type of immune cell that can attack foreign cells, cancer cells, and cells infected with a virus. T cells can also help control immune responses. A T cell is a type of white blood cell. Also called T lymphocyte and thymocyte.
targeted therapy (TAR-geh-ted THAYR-uh-pee)
A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.
tyrosine kinase inhibitor (TY-ruh-seen KY-nays in-HIH-bih-ter)
A drug that interferes with cell communication and growth and may prevent tumor growth. Some tyrosine kinase inhibitors are used to treat cancer.

Table of Links

1http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42190&tt=1&a
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2http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42189&tt=1&a
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3http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=37991&tt=1&a
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4http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=570985&tt=1&
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5http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42192&tt=1&a
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6http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42191&tt=1&a
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7http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=37992&tt=1&a
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8http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=570987&tt=1&
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9http://www.cancer.gov/clinicaltrials
10http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42194&tt=1&a
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11http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42193&tt=1&a
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12http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42196&tt=1&a
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13http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=42195&tt=1&a
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14http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=37993&tt=1&a
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15http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=37994&tt=1&a
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16http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=570988&tt=1&
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17http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=570989&tt=1&
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18http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=566323&tt=1&
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