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Your child can get the very latest treatments for Hodgkin lymphoma through the Leukemia and Lymphoma Program at Seattle Children's. Many children have more than one type of treatment.

Most children who have Hodgkin lymphoma are cured. The success of treatment depends on many factors, some of which are covered below.

As doctors find better treatments through clinical trials, the outlook for children with lymphoma will keep getting better.

Treatment Basics

The most common treatment for Hodgkin lymphoma is chemotherapy using more than one medicine, along with radiation.

Also, researchers are trying the use of high-dose chemotherapy along with a hematopoietic cell, or stem cell, transplant in children whose disease returns after the first round of treatment.

Learn more about the Pediatric Blood and Marrow Transplant Program.

Children's offers all these treatments.

Overall, 80% to 95% of children and teens with Hodgkin lymphoma are cured of their disease.

The cure rate depends on the stage of the lymphoma, symptoms, the size of any tumors, how the child tolerates the therapy and other factors about the disease and your child's health. Children with the mildest form of the disease are cured 95% of the time.

Your child's doctor and health care team will suggest a treatment plan for your child based on the type of lymphoma your child has, the stage of the disease, whether and how many places it has spread and your child's overall health.

Hodgkin Lymphoma Treatment Options

Chemotherapy

Chemotherapy means giving medicines that go throughout your child's body to kill cancer cells.

If your child has Hodgkin lymphoma, your child's doctors will suggest chemotherapy. Based on the type of disease and whether or where it has spread, your child's doctors may use radiation along with chemotherapy. Or, they may suggest chemotherapy as the main treatment for your child's cancer.

Children can get chemotherapy through a vein, by mouth, as a shot into the spinal fluid or a shot in the leg. These medicines spread around the body through the bloodstream. They can help kill cancer cells that are in the blood as well as the lymph system and those that may have spread to other sites.

The exact mix of medicines and how long they are given depend on the type of disease your child has.

Researchers are studying new mixes of medicines to find the best combination for each type of the disease.

For Hodgkin lymphoma, the stage of the disease and other factors affect the risk level of the disease. They also affect the type and length of treatment.

Children and teens with low-risk Hodgkin lymphoma often have three to six months of chemotherapy. For intermediate-risk disease, chemotherapy lasts about four to six months and for high-risk disease about five to seven months.

More than 80% of children in all the risk groups are cured.

Our patients receive chemotherapy at our hospital's main campus in Seattle.

Surgery

The lymph system is a network of vessels that carries fluid and cells around our bodies. Often lymphoma spreads throughout this system with no specific tumor site.

If your child does have a tumor, your child's doctors may suggest surgery. However, in this disease doctors usually do not remove a tumor. The tumor shrinks away with chemotherapy and radiation.

The first surgery your child has may be a biopsy, in which doctors remove a small sample of tumor cells to check for cancer.

Usually they remove a whole lymph node for this purpose. In some cases, doctors may remove a smaller sample for another tumor site.

Radiation

Most children with Hodgkin lymphoma get chemotherapy followed by radiation. The survival rates for this treatment plan are excellent.

Radiation uses high-energy X-rays to kill cancer cells and reduce the size of tumors. A machine sends a dose of radiation through the outer structures, such as the skin and the skull, into deeper sites in the body.

Radiation can cause unpleasant side effects such as nausea, sore throat or mild skin burning or long-term problems such as infertility or other cancers.

Researchers are testing whether some patients with Hodgkin lymphoma need radiation after their chemotherapy. Radiation also can affect the way a child develops.

Researchers are looking for ways to give it in smaller doses or to smaller areas, or to use other treatments instead.

Our patients receive radiation therapy through our partner UW Medicine.

Learn more about Children's Radiation Therapy Service.

Hematopoietic cell transplant, or stem cell transplant

Children whose lymphoma comes back after treatment may have high doses of chemotherapy medicines combined with a hematopoietic cell, or stem cell, transplant.

The chemotherapy medicines are designed to kill cancer cells that remain in the child's body. Such high doses damage the bone marrow, so the marrow cannot make new stem cells that would become blood cells.

Doctors then give the child bone marrow or stem cells through a vein. This is called an infusion.

Sometimes doctors remove the stem cells from the child before chemotherapy and store the cells so they can be returned to the child's body after chemotherapy. This is called an autologous stem cell transplant.

When stem cells come from a donor whose cells closely match the child's cells it is called an allogeneic stem cell transplant.

For Hodgkin lymphoma, most children have standard doses of chemotherapy first.

After a few chemotherapy cycles, doctors remove stem cells from the patient and store these cells.

Once the cancer responds to the chemotherapy, the child gets high-dose chemotherapy and then an infusion of his own stored stem cells.

In rare cases, or if the Hodgkin lymphoma comes back after the transplant, doctors may perform an allogeneic stem cell transplant. For either type of transplant, children get radiation before the transplant or after they recover from the transplant.

Our patients who have a hematopoietic cell, or stem cell, transplant receive this care through Children's and our partner Fred Hutchinson Cancer Research Center.

Learn more about the Pediatric Blood and Marrow Transplant Program.

New Treatments for Hodgkin Lymphoma

Researchers are looking for better treatments for children with lymphoma.

They are studying the best combinations of chemotherapy medicines and ways to use chemotherapy and radiation together with better results. They are also looking for new types of cancer treatments.

Their main goals are to improve cure rates and reduce the risk of long-term effects from the disease and the treatments.

The cancer doctors at Children's are active members of the Children's Oncology Group (COG).

COG is an international organization of childhood cancer specialists who conduct studies on many forms of childhood cancer. Many of our doctors serve on the COG lymphoma committees.

Studies are going on, or are in development, for low-, intermediate- and high-risk types of Hodgkin lymphoma, for new treatments for Hodgkin lymphoma that recurs and for using autologous stem cell transplants in children.

Many of our patients with lymphoma take part in clinical trials. These research studies give children the chance to get the very latest treatment options being studied – options that are not offered at all treatment centers.

Your child's doctor will talk with you in detail about any new treatment that might be a match for your child. Then you can decide whether you want to try this option.

Read more about our research and about follow-up after treatment ends.

Who Treats This at Seattle Children's?

Should your child see a doctor?

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Summer 2014: Good Growing Newsletter

In This Issue

  • Understanding the Power and Influence of Role Models
  • Legal Marijuana Means Greater Poisoning Risks for Children
  • Why Choose Pediatric Emergency Care?

Download Summer 2014 (PDF)