Non-Hodgkin Lymphoma (NHL)

Author: Maria Yiallouros, erstellt 2006/10/26, Editor: Prof. Dr. med. Ursula Creutzig, English Translation: Heidi Krumland, Last modification: 2011/03/29 doi:10.1591/poh.patinfo.nhl.1.20061026 , Kurz-URL: www.kinderkrebsinfo.de/NHL

Non-Hodgkin lymphomas (NHL) account for about 6% of all malignant diseases occurring during childhood and adolescence in Germany: each year about 120 to 130 children are newly diagnosed with NHL. The disease is rare among children under the age of three years. The incidence among boys is about twice as high as in girls (German Childhood Cancer Registry, annual report 2004).

The group of Non-Hodgkin's lymphoma (NHL) includes various malignant diseases of the lymphatic system. Regarding their characteristics, they are closely related to the acute lymphoblastic leukaemia (ALL). NHL develop in the lymph nodes. The malignant cells proliferate rapidly and can spread via the blood system throughout the entire body within a short time.

Due to their rapid growth rate, NHL in children are quick to result in tumours, which are either visible or induce symptoms due to their position. Characteristic symptoms are painless, palpable, painless packages of lymph node swellings of more than three centimetres in diameter and/or breathing difficulties (in case the lung and the respiratory tracts are involved), belly ache, vomiting, indigestion (when the abdomen is affected), headache, paralysis (when the CNS is affected).

The diagnosis is predominantly made by histological examination of lymph nodes or other affected tissue. Sometimes the diagnosis can also be made by a microscopic examination of a bone marrow biopsy, when lymphoma cells are present. In case the percentage of malignant cells in the bone marrow is below 25%, diagnosis is defined as NHL rather than leukaemia. Prior to treatment, further examinations are made to determine the disease’s progress, for instance by imaging procedures. The exact diagnosis of the NHL type is required for assessing the appropriate treatment option. As with leukaemias, this is done by immunologic classification (B-cells or T-cells) and by evaluation of the microscopic features and signs of maturation.

In general, lymphoma cells respond very well to chemotherapy. Therefore, surgery and radiation treatment are rarely used in treating NHL. Thanks to risk adapted treatment protocols, NHL can be cured in more than 80% of the affected children and adolescents.