Childhood Lymphoma Treatment
At MD Anderson's Children's Cancer Hospital, we know your child's health is your top concern. Our renowned experts customize your child's care for lymphoma utilizing the most advanced treatments and techniques with the least impact on your child's growing body.
As part of one of the world's most active cancer centers, Children's Cancer Hospital has remarkable experience and skill in these types of cancer. This can make a difference in your child's outcome.
Chemotherapy
Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.
The lymph system carries fluids throughout the body, which allows lymphoma to spread easily. Chemotherapy can also travel throughout the body easily. That makes it the most common treatment for lymphoma.
Learn more about chemotherapy.
Immunotherapy
The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system’s ability to eliminate cancer.
Learn more about immunotherapy.
The following immunotherapies are used to treat childhood lymphoma:
- Monoclonal antibodies: These attach to specific proteins on the surface of cancer cells or immune cells. They either mark the cancer as a target for the immune system or boost the ability of immune cells to fight the cancer.
Learn more about monoclonal antibodies.
- Immune checkpoint inhibitors: Immune checkpoint inhibitors stop the immune system from turning off before cancer is completely eliminated.
Learn more about immune checkpoint inhibitors.
Stem cell transplantation
A stem cell transplant (also known as a bone marrow transplant) is a procedure that replaces cancerous bone marrow with new, healthy bone marrow stem cells. For pediatric lymphoma, the healthy stem cells can come from a donor or from the patient. Patients usually receive a stem cell transplant after an intense round of chemotherapy that kills the patient’s existing bone marrow cells. Patients usually must stay in the hospital for three to four weeks after the transplant.
Learn more about stem cell transplants.
Radiation therapy
Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.
Doctors sometimes use radiation therapy along with chemotherapy to treat large areas or to minimize discomfort caused by cancerous lymph nodes that are affecting nearby organs or structures. It can also be used to treat tumors that have formed in the central nervous system.
Learn more about radiation therapy.
Surgery
Pediatric lymphoma patients may undergo surgery when tumors are causing severe and immediate problems, like intestinal blocks, severe pain from compressed nerves and organs, or breathing troubles. In rare cases, it can be used to help cure the disease.
Learn more about childhood lymphoma:
Learn more about clinical trials for childhood lymphoma.
B-cell lymphoma survivor: MD Anderson’s expertise saved me and my pregnancy
When I was diagnosed with B-cell lymphoma in August 2023, I wasn’t really frightened for myself. I was more worried about my pregnancy. At the time, I was only about four weeks along with my third child, Catherine, and chemotherapy during the first trimester was not really an option.
Two months is a long time to put off cancer treatment, especially with a disease this aggressive. I knew it would be risky. So, I was extremely grateful to find Dr. Sairah Ahmed and MD Anderson.
Dr. Ahmed is one of two MD Anderson lymphoma specialists who works with pregnant patients regularly. She told me she had helped other women in similar situations. It was so comforting to hear that other pregnant patients had gone through this, too, and that they and their babies had turned out fine.
My B-cell lymphoma diagnosis
I didn’t even know I was pregnant until a few days before my diagnosis. I found out just before having an X-ray and some other scans to determine the cause of severe chest pain. It turned out to be a softball-sized mass, squeezed between my heart and lung, right behind my sternum. A biopsy showed it was primary mediastinal large B-cell lymphoma, a type of non-Hodgkin lymphoma.
The doctors near my home in Lafayette didn’t know what to do. They had treated some pregnant cancer patients, but most were in their second or third trimesters by the time they were diagnosed.
It was scary to be diagnosed with cancer so early in my pregnancy. But once I got to MD Anderson, I felt confident I would be well taken care of. They had done it all before. So, I never felt nervous.
My B-cell lymphoma symptoms
Dr. Ahmed planned for me to start chemotherapy at the beginning of my second trimester. I could have the infusions administered locally near my home in Louisiana.
But the cancer was advancing fast and my cancer symptoms were starting to frighten me. I had drenching night sweats, constant coughing, and a heavy sense of pressure in my chest. I was also getting very little sleep, choking on my food, and my neck was twice its normal size due to swelling.
The disease put so much stress on my heart that I had to be temporarily sedated and put on a ventilator. I ended up starting chemotherapy a week early, in the hopes that it would help stabilize me.
Why I needed a feeding tube
After the first round of chemotherapy, one of the lymph nodes in my chest got so big that it compressed my trachea, compromising my breathing. I had to have a stent put in to keep it open. That was pretty scary. But the hardest part of my cancer treatment turned out to be a fistula — or abnormal hole — that developed between my esophagus and trachea after the second round of chemotherapy.
This meant that anything I ate or drank could get into my lungs, making pneumonia a constant threat. I couldn’t swallow anything at all, not even my saliva.
The only way to correct this problem was surgery. But the surgery was so complex that Dr. Ahmed consulted with thoracic surgeon Dr. Mara Antonoff, and the team made the decision to hold off until after I’d completed cancer treatment and delivered my daughter.
They also consulted with head and neck surgeon Dr. Anastasios Maniakas and plastic surgeon Dr. Paul Shay. Then, they referred me to a high-risk obstetrician who could monitor my pregnancy until I delivered and made plans to perform the surgery soon afterward.
Until then, I needed a way to drain fluid from my esophagus and get nutrition into my body. So, I had a temporary stomach draining tube and feeding tube put in by one of Dr. Antonoff’s colleagues, thoracic surgeon, Dr. Wayne Hofstetter.
My B-cell lymphoma treatment
I finished five rounds of “EPOCH” chemotherapy and one round of “R-CHOP” chemotherapy in mid-February. I had a scheduled C-section on March 14, 2024, at 33 weeks. My daughter was tiny — just 2 pounds, 14 ounces. But her anatomy was perfect, and she was breathing fine. She stayed in the NICU for a month to grow. Now, she weighs nearly 10 pounds and is thriving.
I had surgery at MD Anderson to repair my esophagus and remove part of my trachea on May 2. It required a big team: one plastic surgeon, two thoracic surgeons, and a head and neck surgeon. Each one met with me personally to tell me their role in either the surgery or the backup plan, and they all checked in on me afterward to see how I was doing. I really appreciated that.
The procedure itself was very complex; it took almost 14 hours. But everything went well, and I’m feeling good and getting my strength and weight back.
Dr. Ahmed and her colleagues suspected I was cancer-free after chemotherapy, but they couldn’t be sure until I had scans after delivery. I am pleased to report that they were right: I am officially in remission. So, aside from the surgery I needed to repair the fistula, I won’t require any other cancer treatment.
My life today: cancer-free and almost back to normal, just like I wanted
Today, I feel like a new person. I hadn’t eaten real food in about eight months before the surgery, but after a couple of weeks of healing, I was able to start swallowing purees again. Gradually, I moved back into solid foods, and now I’m eating everything.
I’ll have to wait a little longer before I can drink liquids, though. My vocal cords still don’t close completely when I swallow. Solids are not an issue. But a nerve damaged by the cancer has to finish healing before I can drink things comfortably again.
Aside from being cancer-free and able to eat again, the best news is that I’m back to being a mom and engaging in almost all of my normal activities. That was all I ever really wanted, so even though I’m still healing, my life is great. And I am so thankful to MD Anderson for giving it back to me.
Request an appointment at MD Anderson online or call 1-877-632-6789.
‘How I knew I had lymphoma’: 6 survivors describe their symptoms
Night sweats, persistent fevers and unexplained weight loss are three of the most common symptoms of lymphoma, whether they stem from Hodgkin lymphoma or non-Hodgkin lymphoma. But each one has to meet certain criteria to be considered a possible sign of blood cancer.
In adults, that means:
- Night sweats must happen repeatedly, not be due to menopause-related hot flashes, and you should be drenched in sweat to the point that you have to get up and change your nightclothes and/or sheets at least once before morning.
- Weight loss must reflect 10% or more of your body weight, though you’re not actively trying to lose it.
- Fever must be persistent, higher than 100.4 degrees Fahrenheit and not due to an underlying infection.
“Lymphomas can be divided into two basic categories: aggressive and indolent,” explains lymphoma specialist Saira Ahmed, M.D. “Aggressive lymphomas grow and spread quickly, and can cause significant damage to tissue and organs. Because they are fast-growing, they are most commonly associated with what’s known as ‘B’ symptoms. Indolent lymphomas, on the other hand, are slow-growing. They may not cause any symptoms at all, or cause symptoms that come and go over long periods of time.”
Here's how six of our patients knew they had lymphoma, in their own words.
Swollen lymph nodes
“I went to the doctor about a lump in my throat,” says Rob Moss, who was 49 when he was diagnosed with non-Hodgkin lymphoma. “It grew and shrank several times. My doctor said it was probably a ‘thyroglossal duct cyst,’ or a growth on my thyroid. It turned out to be a swollen lymph node.”
Weight loss
“I lost 20 pounds in a few weeks, was extremely short of breath and was so tired I could barely cross a room without needing to sit down,” says Shelby Wade, who was 23 when she was diagnosed with B-cell lymphoma. “I was also very hoarse and coughing a lot.”
Night sweats
“I experienced severe headaches, a consistent dry cough, weight loss and night sweats for about a month,” says Omar Dirani, who was 30 when he was diagnosed with non-Hodgkin lymphoma. “I thought I was sweating a lot because of all the exercise I was doing.”
Cough
“I thought I had a cold or the flu,” says Jeff Johnson, who was 38 when he was diagnosed with Hodgkin lymphoma. “But the cough that came with it never went away. I kept visiting our family physician and trying different medications, but nothing helped.”
Pain
“I was having back pains on the left side of my kidney area,” recalls Ann Sorhouse, who was 49 when she was diagnosed with non-Hodgkin lymphoma. “But I was doing a lot of physical labor, so I attributed it to muscle strain.”
Itching
“I started having intense itching just a few months after I felt a lump on my collar bone,” recalls Mallory Parrish, who was 32 when she was diagnosed with Hodgkin lymphoma. “At first, I thought it might be a yeast infection, but an over-the-counter anti-fungal treatment didn’t help.”
When to see a doctor about your lymphoma symptoms
Ahmed recommends contacting a physician if your symptoms last more than two weeks without improvement.
“The more symptoms you have, the more concerned you should be,” she explains. “If you have multiple B symptoms that last more than two weeks, see your doctor right away. If you only have one symptom, but it’s inconsistent, just make your doctor aware of it.”
Lymphoma symptoms that you shouldn’t ignore
Some lymphoma symptoms are considered so serious that they warrant an immediate trip to the emergency room. These include:
Spinal cord compression
This can manifest as back pain, leg weakness, bowel or bladder incontinence, vision problems, changes in mental status, or altered sensation in the areas of the leg and buttocks that would typically be in contact with a saddle.
Superior vena cava obstruction
This can appear as difficulty breathing, chest pain, face or neck swelling, or difficulty swallowing. It’s usually due to a mass of clogged lymph nodes in the middle of the chest.
Tumorlysis
Caused by rapidly dying lymphoma cells, this condition can lead to heart arrhythmia, kidney problems and an overall sensation of just not feeling well. If you get blood work done, it may also show you have elevated potassium levels or white blood cell counts.
“Roughly 40% to 50% of patients with aggressive lymphomas show symptoms before their diagnosis,” notes Ahmed. “But only about 10% or less of patients with indolent lymphoma do.”
Lymphoma symptoms can occur with any type or stage of disease, but they’re more commonly seen in fast-growing lymphomas and when the disease is more advanced. That’s why it’s important to get symptoms checked out quickly.
Request an appointment at MD Anderson online or call 1-877-632-6789.