Children with Non-Hodgkin Lymphoma Get More Aggressive Treatment, and Have Better Outcomes Than Adults

One area where the treatment of children really differs from that of adults is in B-cell lymphomas such as diffuse large B-cell lymphoma or Burkitt lymphoma. For one thing, children usually don’t receive R-CHOP — the combination of three chemotherapy drugs, the targeted drug rituximab (Rituxan), and the steroid prednisone. R-CHOP is a standard treatment in most adults with B-cell non-Hodgkin lymphoma.

Kids also get much more aggressive treatment than do adults. “We treat all diffuse large B-cell and Burkitt lymphoma similarly, with a very intense combination chemotherapy regimen,” Dr. Barth says. Chemotherapy uses powerful medicines that travel throughout the body to stop cancer cells from dividing.

It might sound strange to treat children more aggressively than adults, but there’s a good reason for this approach. “In children, the chemotherapy generally is better tolerated. They do have a lot of side effects, but they recover from them well,” he says. Giving more intense doses of chemotherapy has good results, treating children’s cancer more effectively. And many of the side effects that children do have are treatable.

Putting Together the Best Treatment Team

When a child is diagnosed with lymphoma, it’s especially important to find a pediatric oncologist who has a lot of experience treating this kind of cancer. An experienced doctor will be up on the latest research, and will know which therapies have had the most success.

Your treatment team will consist not only of a pediatric oncologist, but may also include a:

• Pediatrician
• Radiation oncologist
• Pediatric surgeon
• Pediatric nurse specialist
• Psychologist
• Social worker

The members of this team are there to answer your questions and guide you through the treatment process. If there is anything you don’t understand while your child is undergoing treatment, don’t be afraid to ask for clarification.

Good Success

Although a cancer diagnosis can be scary, especially when it involves children, parents can take some comfort in knowing that non-Hodgkin lymphoma is very treatable. Doctors are constantly improving the chemotherapy regimens by adjusting the doses and medications, and by introducing new drugs when they become available.

“We’re actually very successful in pediatrics treating non-Hodgkin lymphoma, in particular B-cell lymphomas,” Dr. Barth says. Right now the long-term survival rate of children with B-cell non-Hodgkin lymphomas is over 90%, “which is a much better outcome than we tend to see in adults.”

In those less-common situations where a child doesn’t respond well to the currently available treatments, a clinical trial is always an option. These studies test out new treatments, including immunotherapies, to see how well they work. It’s possible that a treatment under investigation could work better for a child with lymphoma than any of the currently approved treatments.

If your child has tried several treatments and their cancer hasn’t responded, ask your doctor about enrolling them in a clinical trial. A study is an option even for children who are newly diagnosed. In fact, some clinical trials are only open to children who haven’t yet started treatment.

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