Hodgkin Lymphoma (Disease) in Children – In Treatment

The goal of treatment for Hodgkin lymphoma, as with most cancers, is curing the disease with minimal short- and long-term side effects. Most Hodgkin lymphoma in children and adolescents cannot be cured with surgery alone to remove the tumor. There is a less common subtype (lymphocyte predominant histology) that may be managed with surgery alone if classified as stage I and if doctors are able to completely remove the tumor surgically.

The majority of children with Hodgkin disease are treated with chemotherapy and many receive “combined modality” therapy that includes radiation. Carefully selected children are treated with only chemotherapy. Stem cell transplant may be used for treatment if Hodgkin disease has come back after successful treatment (relapse) or if the cancer does not respond to conventional treatments (refractory).

Initial therapy depends on the stage and bulk (size) of disease as well as with the subtype of Hodgkin lymphoma. Patients with lower stage (or early stage) disease, such as IA and IIA, receive less chemotherapy than higher stage patients. The amount of therapy can also be affected by whether a patient is designated a rapid early responder (RER), meaning the cancer responds quickly to initial treatment or a slow early responder (SER), meaning the cancer responds more slowly to initial treatment. Currently, RER patients receive less total treatment than patients with the same disease stage designated as SER. While most patients are treated with both chemotherapy and radiation therapy, efforts are underway to identify RER patients who can be treated without radiation therapy while still maintaining equally high survival rates.

When chemotherapy is administered, it is usually with a combination of four or more drugs. Side effects can include low blood counts, increased infection risk, hair loss, infertility, nausea and vomiting, fatigue, lung damage, heart damage, and increased risk of cancer later in life.

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