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T cell childhood non Hodgkin lymphoma (NHL)

Read about T cell non Hodgkin lymphoma and how it is treated.

T cell non Hodgkin lymphoma in children is very rare.

Non Hodgkin lymphoma in children

Non Hodgkin lymphoma (NHL) is a complicated disease and there are many different types. 

The most important thing is whether NHL is low grade or high grade. Low grade usually means slow growing and high grade is fast growing. Low grade tumours are common in adults but in children most NHLs are high grade.

Because there are so many different types of lymphomas doctors put them into different groups. They call this classification.

Classification

NHL can be classified in several different ways according to:

  • the type of cell affected (B cell or T cell)
  • how fast they tend to grow (their grade)
  • how the cells look under a microscope
  • how the lymphoma behaves clinically
  • what genetic abnormalities the tumour has

Types of NHL

There are 3 main types of NHL found in children. Like many illnesses, they have quite complicated names. These are:

  • non cleaved cell (Burkitt lymphoma)
  • lymphoblastic (usually T cell) lymphoma
  • large cell lymphoma

The lymphoblastic type is the most common type of childhood T cell NHL.
 

Stages of non Hodgkin lymphoma in children

Childhood NHL has 4 stages. The stage depends on how many lymph nodes are affected by the lymphoma and whether other organs in the body are also affected.

NHL is more common in boys than in girls, the reasons for this are unclear.

While adults with NHL mainly have disease in their lymph nodes, children typically have lymphoma in their:

  • chest
  • abdomen
  • head and neck area

Stage 1

Stage 1 means there is lymphoma in one part of the body, or one group of lymph nodes outside the tummy (abdomen) or chest.

Stage 2

Stage 2 means the lymphoma is one of the following:

  • only in one part of the body and in the lymph nodes around it
  • in 2 or more areas or groups of lymph nodes on one side of the diaphragm (the muscle that divides the chest and abdominal cavity and helps with breathing)
  • in the stomach or bowel

Stage 3

Stage 3 means the lymphoma is one of the following:

  • in parts of the body or lymph nodes on both sides of the diaphragm
  • within the chest
  • in more than one place in the abdomen
  • around the spine

Stage 4

The lymphoma has spread to another part of the body such as the bone, liver or brain.

Treatment for T cell NHL in children

Chemotherapy is the most important treatment for children with NHL. Children usually have a combination of chemotherapy drugs and steroids. These include:

  • vincristine
  • daunorubicin
  • asparaginase
  • cytarabine
  • methotrexate
  • cyclophosphomaide
  • 6-mercaptopurine
  • 6-thioguanine
  • steroid drugs – prednisolone and dexamethasone

Some children also have radiotherapy to the brain to try and prevent the lymphoma from spreading there.

The treatment may last from a few months to up to 2 years. Your child’s doctor will discuss the treatment options with you.

High dose chemotherapy with a bone marrow transplant is sometimes used if the NHL comes back (recurs) after initial treatment.

Side effects

The side effects of the treatment will depend on the particular treatment being used. Your child’s doctor will discuss this with you before treatment starts. Possible side effects include:

  • feeling and being sick
  • temporary hair loss
  • an increased risk of infection
  • bruising and bleeding
  • tiredness
  • diarrhoea

Outlook for children with NHL

For many years the chance of being cured for children with NHL has been getting higher.

A study in 2008 reported that around 80% of children with stage 4 T cell lymphoma are likely to be cured. Your child's doctor can give you more information about the likely chance of cure in their case.

Coping when your child has cancer

It is understandably devastating when a child is diagnosed with cancer. Although many children with cancer are successfully treated, it is a difficult time for everyone affected.

As well as the doctors and nurses on the ward, you and your child will be supported by a number of professionals during and after treatment. These will include your GP, cancer nurse specialists, social workers, play specialists and a psychologist or psychotherapist.

Talking to other people who are experiencing the same thing can also help. Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.

There are children's organisations that you can contact for help and support.

Last reviewed: 
12 Nov 2012
  • Cancer and its management (6th edition)
    J Tobias and R Hochhauser
    Wiley Blackwell, 2010

  • Intensive ALL-type therapy without local radiotherapy provides a 90% event-free survival for children with T-cell lymphoblastic lymphoma: a BFM group report
    A. Reiter (and others)
    Blood. 2000 Jan 15;95 (2):416-21

  • Principles and practice of oncology (10th edition)
    VT. De Vita, S. Hellman, and SA.Rosenberg
    Walters Kluwer, 2015

  • Shortened intensified multi-agent chemotherapy and non-cross resistant maintenance therapy for advanced lymphoblastic lymphoma in children and adolescents: report from the Children's Oncology Group
    M. Abromowitch (and others)
    British Journal of Haematology. 2008 Oct;143 (2):261-7

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