Children with non-Hodgkin lymphoma are treated at Dana-Farber/Boston Children's through the Childhood Lymphoma Program in our Childhood Hematologic Malignancy Center. Dana-Farber/Boston Children's offers internationally renowned care for children with cancers of the blood and immune system.
Dana-Farber/Boston Children's also offers a wide array of support services and programs for pediatric patients and their families during and after cancer treatment.
Our Treatment Approach
The first major factor in deciding on a treatment strategy for non-Hodgkin lymphoma is through determining the specific type of lymphoma. The next important consideration is whether the cancer is localized to a specific part of the body (low stage; stage I or II) or has spread to different parts of the body (advanced stage; stage III or IV). Generally, stronger treatment is needed for successful treatment of advanced stage lymphoma.
Non-Hodgkin lymphoma treatment may include:
- Chemotherapy: By far the most common treatment for non-Hodgkin lymphoma is chemotherapy. Chemotherapy is drug treatment that works by interfering with the cancer cells' ability to grow or reproduce. Several different chemotherapy drugs are combined to provide the most effective treatment for the lymphoma. Commonly used drugs in the treatment of lymphoma are cyclophosphamide, doxorubicin, vincristine, prednisone, and methotrexate, among others. Different chemotherapy drugs work in different ways. Chemotherapy may be given by mouth, by injection into the muscle or directly into the vein (IV), or as a direct injection into the spinal fluid through a needle (lumbar puncture). Chemotherapy into the spinal fluid is commonly used as part of the treatment of NHL in children.
- Targeted therapy: Antibodies, immune cell therapies, and drugs that target lymphoma cells directly or help the body's own immune system to attack the cancer have become important tools in fighting lymphoma. Rituximab is an antibody that targets CD20 on mature B-cell lymphomas. Brentuximab is an antibody-chemotherapy combination that targets lymphomas with CD30 expression, such as anaplastic large cell lymphoma. Other types of immunotherapy are currently being investigated in the treatment of lymphoma.
- CAR T-cell therapy: CAR T-cell therapy is a promising new immunotherapy treatment for complex childhood non-Hodgkin lymphoma cases. We typically treat childhood B-cell lymphomas, such as Burkitt lymphoma with chemotherapy. If chemotherapy isn’t able to cure the cancer, our doctors may suggest CAR T-cell therapy as a treatment option. Dana-Farber/Boston Children's uses KYMRIAH® to treat children and young adults with relapsed or refractory large B-cell lymphomas.
- Stem cell transplant: When a lymphoma is completely resistant to initial treatment or recurs despite initial treatment, high dose chemotherapy followed by a stem cell transplant may be a good treatment option. In a stem cell transplant for NHL, the transplanted bone marrow is usually the patient's own (autologous), rather than someone else's (allogeneic).
- Radiation therapy: High-energy rays (radiation) from a specialized machine are used to damage or kill cancer cells and shrink tumors. This type of therapy is not commonly used to treat non-Hodgkin lymphoma in children.
- Surgery: This option may be required to biopsy the tumor to make an accurate diagnosis, or to confirm that the tumor has responded well to treatment, but it usually does not have a role in the treatment of pediatric NHL.
The lymphoma specialists at Dana-Farber/Boston Children's determine the best approach to treatment for your child's unique situation, based on the type of lymphoma, the extent of the disease, your child's medical condition, your child's and your family's preferences, and the most up-to-date medical knowledge about lymphoma therapies.