Childhood Lymphoma Treatment
At MD Anderson's Children's Cancer Hospital, we know your child's health is your top concern. Our renowned experts customize your child's care for lymphoma utilizing the most advanced treatments and techniques with the least impact on your child's growing body.
As part of one of the world's most active cancer centers, Children's Cancer Hospital has remarkable experience and skill in these types of cancer. This can make a difference in your child's outcome.
Chemotherapy
Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.
The lymph system carries fluids throughout the body, which allows lymphoma to spread easily. Chemotherapy can also travel throughout the body easily. That makes it the most common treatment for lymphoma.
Learn more about chemotherapy.
Immunotherapy
The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system¡¯s ability to eliminate cancer.
Learn more about immunotherapy.
The following immunotherapies are used to treat childhood lymphoma:
Immune checkpoint inhibitors: Immune checkpoint inhibitors stop the immune system from turning off before cancer is completely eliminated. They help cancer-fighting immune cells, called T cells, mount a longer-lasting response against the disease.
Learn more about immune checkpoint inhibitors.
CAR T cell therapy: T cells are immune system cells that help the immune system respond to disease and directly kill diseased cells. In Chimeric antigen receptor (CAR) T cell therapy, T cells are modified so they can recognize and attack cancer cells. Through clinical trials, CAR T cell therapy is used to treat all different types of lymphoma. It is FDA-approved to treat certain kinds of B-cell lymphoma, a sub-type of non-Hodgkin lymphoma.
Learn more about CAR T cell therapy.
Targeted Therapy
Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or?target, these molecules or the cancer-causing genes that create them.??
Learn more about targeted therapy.
Stem cell transplantation
A stem cell transplant (also known as a bone marrow transplant) is a procedure that replaces cancerous bone marrow with new, healthy bone marrow stem cells. For pediatric lymphoma, the healthy stem cells can come from a donor or from the patient. Patients usually receive a stem cell transplant after an intense round of chemotherapy that kills the patient¡¯s existing bone marrow cells. Patients usually must stay in the hospital for three to four weeks after the transplant.
Learn more about stem cell transplants.
Radiation therapy
Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.
Doctors sometimes use radiation therapy along with chemotherapy to treat large areas or to minimize discomfort caused by cancerous lymph nodes that are affecting nearby organs or structures. It can also be used to treat tumors that have formed in the central nervous system.
Radiation therapy is a critical treatment for adult lymphoma. Because it can cause long-term side effects, doctors are limiting its use in pediatric patients.
Learn more about radiation therapy.
Surgery
Pediatric lymphoma patients may undergo surgery when tumors are causing severe and immediate problems, like intestinal blocks, severe pain from compressed nerves and organs, or breathing troubles. In rare cases, it can be used to help cure the disease.
Learn more about childhood lymphoma:
Learn more about clinical trials for childhood lymphoma.
B-cell lymphoma survivor: MD Anderson¡¯s expertise saved me and my?pregnancy
When I was diagnosed with B-cell lymphoma in August 2023, I wasn¡¯t really frightened for myself. I was more worried about my pregnancy. At the time, I was only about four weeks along with my third child, Catherine, and chemotherapy during the first trimester was not really an option.?
Two months is a long time to put off cancer treatment, especially with a disease this aggressive. I knew it would be risky. So, I was extremely grateful to find and MD Anderson. ?
Dr. Ahmed is one of two MD Anderson lymphoma specialists who works with pregnant patients regularly. She told me she had helped other women in similar situations. It was so comforting to hear that other pregnant patients had gone through this, too, and that they and their babies had turned out fine. ?
My B-cell lymphoma diagnosis?
I didn¡¯t even know I was pregnant until a few days before my diagnosis. I found out just before having an X-ray and some other scans to determine the cause of severe chest pain. It turned out to be a softball-sized mass, squeezed between my heart and lung, right behind my sternum. A biopsy showed it was primary mediastinal large B-cell lymphoma, a type of non-Hodgkin lymphoma.??
The doctors near my home in Lafayette didn¡¯t know what to do. They had treated some pregnant cancer patients, but most were in their second or third trimesters by the time they were diagnosed. ?
It was scary to be diagnosed with cancer so early in my pregnancy. But once I got to MD Anderson, I felt confident I would be well taken care of. They had done it all before. So, I never felt nervous.?
My B-cell lymphoma symptoms?
Dr. Ahmed planned for me to start chemotherapy at the beginning of my second trimester. I could have the infusions administered locally near my home in Louisiana.?
But the cancer was advancing fast and my cancer symptoms were starting to frighten me. I had drenching night sweats, constant coughing, and a heavy sense of pressure in my chest. I was also getting very little sleep, choking on my food, and my neck was twice its normal size due to swelling.
The disease put so much stress on my heart that I had to be temporarily sedated and put on a ventilator. I ended up starting chemotherapy a week early, in the hopes that it would help stabilize me.?
Why I needed a feeding tube
After the first round of chemotherapy, one of the lymph nodes in my chest got so big that it compressed my trachea, compromising my breathing. I had to have a stent put in to keep it open. That was pretty scary. But the hardest part of my cancer treatment turned out to be a fistula ¡ª or abnormal hole ¡ª that developed between my esophagus and trachea after the second round of chemotherapy.
This meant that anything I ate or drank could get into my lungs, making pneumonia a constant threat. I couldn¡¯t swallow anything at all, not even my saliva.
The only way to correct this problem was surgery. But the surgery was so complex that Dr. Ahmed consulted with thoracic surgeon , and the team made the decision to hold off until after I¡¯d completed cancer treatment and delivered my daughter.
They also consulted with head and neck surgeon and plastic surgeon . Then, they referred me to a high-risk obstetrician who could monitor my pregnancy until I delivered and made plans to perform the surgery soon afterward.
Until then, I needed a way to drain fluid from my esophagus and get nutrition into my body. So, I had a temporary stomach draining tube and feeding tube put in by one of Dr. Antonoff¡¯s colleagues, thoracic surgeon, .?
My B-cell lymphoma treatment?
I finished five rounds of ¡°EPOCH¡± chemotherapy and one round of ¡°R-CHOP¡± chemotherapy in mid-February. I had a scheduled C-section on March 14, 2024, at 33 weeks. My daughter was tiny ¡ª just 2 pounds, 14 ounces. But her anatomy was perfect, and she was breathing fine. She stayed in the NICU for a month to grow. Now, she weighs nearly 10 pounds and is thriving.?
I had surgery at MD Anderson to repair my esophagus and remove part of my trachea on May 2. It required a big team: one plastic surgeon, two thoracic surgeons, ?and a head and neck surgeon. Each one met with me personally to tell me their role in either the surgery or the backup plan, and they all checked in on me afterward to see how I was doing. I really appreciated that.?
The procedure itself was very complex; it took almost 14 hours. But everything went well, and I¡¯m feeling good and getting my strength and weight back. ?
Dr. Ahmed and her colleagues suspected I was cancer-free after chemotherapy, but they couldn¡¯t be sure until I had scans after delivery. I am pleased to report that they were right: I am officially in remission. So, aside from the surgery I needed to repair the fistula, I won¡¯t require any other cancer treatment.
My life today: cancer-free and almost back to normal, just like I wanted?
Today, I feel like a new person. I hadn¡¯t eaten real food in about eight months before the surgery, but after a couple of weeks of healing, I was able to start swallowing purees again. Gradually, I moved back into solid foods, and now I¡¯m eating everything. ?
I¡¯ll have to wait a little longer before I can drink liquids, though. My vocal cords still don¡¯t close completely when I swallow. Solids are not an issue. But a nerve damaged by the cancer has to finish healing before I can drink things comfortably again.?
Aside from being cancer-free and able to eat again, the best news is that I¡¯m back to being a mom and engaging in almost all of my normal activities. That was all I ever really wanted, so even though I¡¯m still healing, my life is great. And I am so thankful to MD Anderson for giving it back to me.?
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