Hodgkin lymphoma in children
Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, tonsils, liver, bone marrow, and other organs of the immune system. The immune system protects us against diseases and infections.
Cancer
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
Read Article Now Book Mark ArticleThis article is about classical Hodgkin lymphoma in children, the most common type.
Hodgkin lymphoma - Animation
Did you ever touch your neck and feel a bump on one or both sides? Usually, it’s just a swollen gland or lymph node that’s caused by a cold or other infection. But occasionally, swollen lymph nodes can be a sign of cancer, perhaps a cancer called Hodgkin lymphoma. These are your lymph nodes. You’ll find them not only on your neck, but in your armpits and groin too. They’re a part of your body’s normal defense system, which protects you against invading viruses and bacteria. Hodgkin lymphoma is a type of cancer that starts inside the lymph nodes. What causes Hodgkin lymphoma isn’t known, but having the Epstein-Barr virus or HIV, may increase your risk. So, what are the signs of Hodgkin lymphoma? In addition to having swollen lymph nodes, you may feel tired and have no appetite. Some people wake up in the middle of the night soaked in sweat. That’s called night sweats. Remember, though, that these symptoms can occur with many different conditions. So if you have them, don’t panic. But do see your doctor, who can tell you for sure what’s causing your symptoms. If your doctor suspects that you have Hodgkin lymphoma, your doctor will probably cut and remove a small piece of tissue from your lymph node, called a biopsy, and the samples will be sent to a lab to look for cancer cells. If cancer is diagnosed, other tests are used to stage it, in other words, to see whether the disease has spread, and if so, how far it’s spread. That helps your doctor find the right treatment. If you have Hodgkin lymphoma, most often the treatment involves radiation therapy, chemotherapy, or a combination of both. People who don’t respond to these treatments sometimes need a bone marrow transplant. While you’re being treated for Hodgkin lymphoma, you may need other therapies to help you feel better. That might include antibiotics to fight an infection, or a blood transfusion to add red blood cells when they’re low. Getting diagnosed with any type of cancer can be difficult to hear. But, you should know that Hodgkin lymphoma is one of the most curable types of cancer. Even if the disease has spread, your chances of survival are very high. You can improve your odds by following the entire treatment plan. Once your lymphoma has been treated, you’ll need to see your doctor regularly for check-ups to make sure the cancer hasn’t returned, and to monitor for any side effects your treatment may have caused.
Causes
In children, Hodgkin lymphoma is more likely to occur between the ages 15 to 19 years. The cause of this type of cancer is unknown. The following factors, however, may play a role in Hodgkin lymphoma in children:
- Epstein-Barr virus, the virus that causes mononucleosis
Mononucleosis
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
Read Article Now Book Mark Article - Some diseases where the immune system does not work well
- A family history of Hodgkin lymphoma
Common early childhood infections also may increase the risk.
Symptoms
Symptoms of Hodgkin lymphoma include:
- Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands)
- Unexplained fever
-
Unexplained weight loss
Unexplained weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
Read Article Now Book Mark Article - Night sweats
- Feeling weak or tired
- Loss of appetite
Exams and Tests
Your health care provider will take your child's medical history. Your provider will do a physical exam to check for swollen lymph nodes.
Your provider may perform these lab tests when Hodgkin disease is suspected:
-
Blood chemistry tests - including protein levels, liver function tests, kidney function tests, and uric acid level
Blood chemistry tests
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
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Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Chest x-ray, which often shows signs of a mass in the area between the lungs
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Chest CT scan
Chest CT scan
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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A lymph node biopsy confirms the diagnosis of Hodgkin lymphoma.
Lymph node biopsy
A lymph node biopsy is the removal of lymph node tissue for examination under a microscope. The lymph nodes are small glands that make white blood ce...
Read Article Now Book Mark ArticleIf a biopsy shows that your child has lymphoma, more tests will be done to find out how far the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up.
Staging
Cancer staging is a way to describe how much cancer is in your body and where it is located. Staging helps determine where the original tumor is, ho...
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CT scan of the neck, chest, abdomen, and pelvis
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Bone marrow biopsy
Bone marrow biopsy
A bone marrow biopsy is the removal of marrow from inside one of your bones. Bone marrow is the soft tissue inside bones that helps form blood cells...
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PET scan
PET scan
A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body...
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Immunophenotyping is a lab test used to identify cells, based on the types of antigens or markers on the surface of the cell. This test is used to diagnose the specific type of lymphoma by comparing the cancer cells to normal cells of the immune system.
Treatment
You may choose to seek care at a children's cancer center.
Children's cancer center
A children's cancer center is a place dedicated to treating children with cancer. It may be a hospital or, it may be a unit inside a hospital. Thes...
Read Article Now Book Mark ArticleTreatment will depend on the risk group your child falls into. Other factors that will be considered include:
- Your child's age
- Sex
- Treatment side effects
Your child's lymphoma will be grouped as low-risk, intermediate-risk, or high-risk based on:
- The type of Hodgkin lymphoma (there are different forms of Hodgkin lymphoma)
- The stage (where the disease has spread)
- The presence of fever, weight loss, and night sweats
Chemotherapy is most often the first treatment.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark Article- Your child may need to stay in the hospital at first. But the chemotherapy medicines are typically given in a clinic, and your child will still live at home.
- Chemotherapy is given into the veins (IV) and sometimes by mouth.
(IV
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
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Your child may also receive radiation therapy, depending on the response to chemotherapy, using high-powered x-rays aimed at cancer-affected areas.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
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-
Immunotherapy that targets and kills specific cancer cells
Immunotherapy
Immunotherapy is a type of cancer treatment that relies on the body's infection-fighting system (immune system). It uses substances made by the body...
Read Article Now Book Mark Article - High-dose chemotherapy may be followed by stem cell transplant (using your child's own stem cells)
Stem cell transplant
A bone marrow transplant is a procedure to replace damaged or diseased bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatt...
Read Article Now Book Mark Article - Surgery is not commonly used to remove this type of cancer, but may be needed in rare cases
Having a child with cancer is one of the hardest things you will ever deal with as a parent. Explaining what it means to have cancer to your child will not be easy. You will also need to learn how to get help and support so you can cope more easily.
Explaining what it means to have cancer...
Learning that your child has cancer can feel overwhelming and scary. You want to protect your child, not only from the cancer, but also from the fea...
Read Article Now Book Mark ArticleLearn how to get help and support
Having a child with cancer is one of the hardest things you will ever deal with as a parent. Not only are you filled with worry and concern, but you...
Read Article Now Book Mark ArticleSupport Groups
Having a child with cancer can be stressful. Joining a support group where other parents or families share common experiences may help ease your stress.
- Leukemia and Lymphoma Society -- www.lls.org
- The National Children’s Cancer Society -- thenccs.org/
Outlook (Prognosis)
Hodgkin lymphoma is curable in most cases. Even if this form of cancer returns, there is still a moderate chance of a cure.
Your child will need to have regular exams and imaging tests for years after treatment. This will help your provider check for signs of the cancer returning and for any long-term treatment effects.
Possible Complications
Treatments for Hodgkin lymphoma may have complications. Side effects of chemotherapy or radiation therapy may appear months or years after treatment. These are called "late effects." It is important to talk about treatment effects with your health care team. What to expect in terms of late effects depends on the specific treatments your child receives. The concern of late effects must be balanced by the need to treat and cure the cancer.
Late effects
Today's cancer treatments help cure most children with cancer. These treatments also may cause health problems later on. These are called late effe...
Read Article Now Book Mark ArticleContinue to follow up with your child's provider to monitor and help prevent these complications.
When to Contact a Medical Professional
Contact your provider if your child has swollen lymph nodes with a fever that stays for a long time or has other symptoms of Hodgkin lymphoma. Contact your child's provider if your child has Hodgkin lymphoma and has side effects from the treatment.
Reviewed By
Rachel Offenbacher, MD, Pediatric Hematology & Oncology, The Children's Hospital at Montefiore, Bronx, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
American Cancer Society website. Hodgkin lymphoma. www.cancer.org/cancer/types/hodgkin-lymphoma.html. Accessed August 22, 2024.
Hochberg J, Goldman SC, Cairo MS. Lymphoma. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 545.
National Cancer Institute website. Childhood Hodgkin lymphoma treatment (PDQ) - health professional version. www.cancer.gov/types/lymphoma/hp/child-hodgkin-treatment-pdq. Updated April 30, 2024. Accessed August 22, 2024.
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