Non-Hodgkin Lymphoma (NHL)

Non-Hodgkin lymphomas (NHL) are malignant diseases of the lymphatic system. They account for about 6,5 % of all malignant diseases occurring during childhood and adolescence in Germany: each year about 115 children and teenagers 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.

Author: Maria Yiallouros, erstellt 2006/10/26, Editor: PD Dr. med. Gesche Tallen, Reviewer: Prof. Dr. med. Ursula Creutzig, English Translation: Heidi Krumland, Last modification: 2015/07/30 doi:10.1591/poh.patinfo.nhl.1.20061026

Non-Hodgkin lymphomas (NHL) are malignant diseases of the lymphatic system. Like the Hodgkin disease (Hodgkin lymphoma), they belong to the group of malignant lymphoma.

The group of Non-Hodgkin 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 packages of swollen lymph nodes 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.

References

  1. Reiter A: Non-Hodgkin Lymphoma in Children and Adolescents. Klinische Padiatrie 2013, 225(S 01):S87-S93 [PMID: 23700066]
  2. Burkhardt B, Oschlies I, Klapper W, Zimmermann M, Woessmann W, Meinhardt A, Landmann E, Attarbaschi A, Niggli F, Schrappe M, Reiter A: Non-Hodgkin's lymphoma in adolescents: experiences in 378 adolescent NHL patients treated according to pediatric NHL-BFM protocols. Leukemia 2011, 25: 153 [PMID: 21030984]
  3. Mann G, Attarbaschi A, Burkhardt B, Niggli F, Klapper W, Ludwig WD, Schrappe M, Zimmermann M, Gadner H, Reiter A, Berlin-Frankfurt-Münster Group: Clinical characteristics and treatment outcome of infants with non-Hodgkin lymphoma. British journal of haematology 2007, 139: 443 [PMID: 17868047]
  4. Reiter A, Mann G, Parwaresch R: Non-Hodgkin-Lymphome. In: Gadner H, Gaedicke G, Niemeyer C, Ritter J, editors. Pädiatrische Hämatologie und Onkologie Berlin, Heidelberg, New York: Springer Verlag, 2006, 733 [ISBN: 3540037020
  5. Gadner H, Gaedicke G, Niemeyer CH, Ritter J (Hrsg): Pädiatrische Hämatologie und Onkologie. Springer-Verlag 2006 [URI: http://www.springer.com/ medicine/ pediatrics/ book/ 978-3-540-03702-6]
  6. Henze G: Maligne Non-Hodgkin-Lymphome, in Gutjahr P: Krebs bei Kindern und Jugendlichen. Deutscher Ärzte-Verlag Köln 5. Aufl. 2004, 328 [ISBN: 3769104285
  7. Gutjahr P: Krebs bei Kindern und Jugendlichen. Deutscher Ärzte-Verlag Köln 5. Aufl. 2004 [ISBN: 3769104285