Localized Non-Hodgkin Lymphoma in Children and Adolescents
Disseminated Childhood B-cell Non-Hodgkin Lymphoma
Disseminated Childhood Lymphoblastic Lymphoma
Disseminated 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.

Standard treatment of localized non-Hodgkin lymphoma in children and adolescents is usually surgery followed by combination chemotherapy.

New treatments are being studied in clinical trials for localized non-Hodgkin lymphoma in children and adolescents.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry 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.

Standard treatment for disseminated B-cell (Burkitt and Burkitt-like) non-Hodgkin lymphoma in children and adolescents is usually combination chemotherapy with CNS prophylaxis (intrathecal chemotherapy).

Monoclonal antibody therapy combined with chemotherapy is being studied in clinical trials for disseminated B-cell non-Hodgkin lymphoma in children and adolescents.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood large cell lymphoma ⁹, stage III childhood small noncleaved cell lymphoma ¹⁰, stage IV childhood large cell lymphoma ¹¹ and stage IV childhood small noncleaved cell lymphoma ¹².

Standard treatment of disseminated lymphoblastic lymphoma in children and adolescents is usually combination chemotherapy with or without radiation therapy to the brain.

New combinations of chemotherapy, with and without CNS prophylaxis (intrathecal chemotherapy), are being studied in clinical trials for disseminated lymphoblastic lymphoma in children and adolescents.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood lymphoblastic lymphoma ¹³ and stage IV childhood lymphoblastic lymphoma ¹⁴.

Standard treatment of disseminated anaplastic large-cell lymphoma in children and adolescents is usually combination chemotherapy with or without CNS prophylaxis (intrathecal chemotherapy).

New combinations of chemotherapy are being studied in clinical trials for disseminated anaplastic large-cell lymphoma in children and adolescents.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood anaplastic large cell lymphoma ¹⁵ and stage IV childhood anaplastic large cell lymphoma ¹⁶.

Standard treatment of recurrent childhood non-Hodgkin lymphoma in children and adolescents may include the following:

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

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood non-Hodgkin lymphoma ¹⁷.

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

• Surgery with or without radiation therapy.
• Combination chemotherapy.

Some of the treatments being studied in clinical trials include the following:

• Monoclonal antibody therapy combined with chemotherapy.
• Stem cell transplant followed by donor lymphocyte infusion or an infusion of T-cell lymphocytes that have been treated in the laboratory.

Glossary Terms

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.

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.

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.

Treatment with drugs that kill cancer cells.

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 a clinical study.

Chemotherapy or radiation therapy given to the central nervous system (CNS) as a preventive treatment. It kills cancer cells that may be in the brain and spinal cord, even though no cancer has been detected there. Also called central nervous system prophylaxis, central nervous system sanctuary therapy, and CNS sanctuary therapy.

Treatment using more than one anticancer drug.

Scatter or distribute over a large area or range.

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.

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.

The complex group of organs and cells that defends the body against infections and other diseases.

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.

Restricted to the site of origin, without evidence of spread.

A type of white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infections and other diseases.

Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.

A disease in which cells of the lymphatic system grow excessively. Lymphoproliferative disorders are often treated like cancer.

A type of protein made in the laboratory that can locate and 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.

Any of a large group of cancers of the immune system. Non-Hodgkin lymphomas can occur at any age and are often marked by enlarged lymph nodes, fever, and weight loss. There are many different types of non-Hodgkin lymphoma, which can be divided into aggressive (fast-growing) and indolent (slow-growing) types and can be classified as either B-cell or T-cell non-Hodgkin lymphoma. B-cell non-Hodgkin lymphomas include Burkitt lymphoma, 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 related to lymphoproliferative disorders following 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.

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 radiotherapy and irradiation.

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.

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.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called standard of care or best practice.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

One type of white blood cell that attacks virus-infected cells, foreign cells, and cancer cells. T cells also produce a number of substances that regulate the immune response. Also called T lymphocyte.

Treatment.