What is childhood Hodgkin's disease?

Hodgkin's disease is a kind of lymphoma, an uncommon cancer that starts in the lymph system. The lymph system includes the lymph nodes, lymph vessels, and other parts of the body's immune and blood-forming systems, such as the spleen and bone marrow. The lymph system makes, stores, and carries infection-fighting white blood cells called lymphocytes. Lymph nodes and lymph vessels are located throughout the body.

Hodgkin's disease, also called Hodgkin's lymphoma, is one of the most curable cancers.

How does it occur?

There are no known risk factors for childhood Hodgkin's lymphoma. It is very rare in children under the age of 5. It seems to affect boys more often than girls.

For reasons that are not known, when people have Hodgkin's disease their bodies make too many abnormal lymphocytes. These cancer cells crowd into the lymph nodes and may also invade other parts of the body. Tumors may then grow and interfere with normal body functions.

What are the symptoms?

Symptoms of Hodgkin's disease are:

• painless swelling of lymph nodes, in the neck, armpits, or groin
• fever
• night sweats
• unexplained weight loss
• itching
• tiredness.
   

How is it diagnosed?

Your child's health care provider will ask about symptoms and examine your child. A sample of tissue will be taken from a swollen lymph node and examined under a microscope. This removal of a sample of tissue is called a biopsy. If your child has Hodgkin's disease, unusual cells called Reed-Sternberg cells will be found in the tissue.

If Hodgkin's disease is found, more tests will be done to learn the stage or the extent of the disease. These tests may include:

• blood tests
• chest x-rays
• CT scans of the chest and abdomen
• biopsy of the bone marrow to see if the disease has spread there.
   

How is it treated?

The diagnosis of Hodgkin's disease is classified into stages, depending on the areas of lymph nodes and other organs affected. There are several types of Hodgkin's disease. Treatment will depend on the type and stage of disease, as well as your child's general health.

Radiation therapy or anticancer drugs (chemotherapy) are used to shrink tumors and kill cancer cells. Side effects of chemotherapy include nausea and hair loss. Nausea can be controlled with drugs. Hair loss cannot be controlled. Children are also at risk for serious infections during and after treatment.

If Hodgkin's is not cured with chemotherapy, stem cells (immature blood cells) may be transplanted from your child's blood or bone marrow or from a donor's blood or marrow. Other types of blood cell treatments are also available to help the child maintain a healthy bone marrow.

Marrow is taken from the bones before treatment. The marrow is then frozen, and the child is given high-dose chemotherapy with or without radiation therapy to treat the cancer. The marrow taken out is then thawed and given back through a needle in a vein to replace the marrow that was destroyed by the chemotherapy.