Research on the causes, diagnosis, and treatment of childhood non-Hodgkin lymphoma is being done at many medical centers, university hospitals, and other institutions across the nation. As noted in the section "Do We Know What Causes Childhood Non-Hodgkin Lymphoma?" scientists are making great progress in understanding how changes in DNA can cause normal lymphocytes to develop into lymphoma.

Greater understanding of the genes (regions of DNA) involved in certain translocations that often occur in non-Hodgkin lymphoma is providing insight into why these cells may grow too rapidly, live too long, and not develop into mature cells that participate in a normal immune reaction. Eventually, this information may be used in developing therapy to block the effect of the abnormal DNA of cancer cells and restore normal controls on cell growth.

Progress in understanding DNA changes in non-Hodgkin lymphoma has already provided vastly improved and highly sensitive tests for detecting this disease. Tests such as the polymerase chain reaction (PCR) can identify non-Hodgkin lymphoma cells based on their gene translocations or rearrangements. This test can find one tumor cell among a million normal cells. It is useful in determining how completely the lymphoma has been destroyed by treatment and whether a relapse is likely.

Several important questions are now being studied in clinical trials, such as:

• Can all localized (stages I and II) non-Hodgkin lymphoma be treated similarly?
• What is the best length of treatment of each type of non-Hodgkin lymphoma?
• Do certain drugs that support more rapid recovery of normal bone marrow cells ("growth factors") have a place in the treatment of children with non-Hodgkin lymphoma?
• Can less intense treatment provide as good an outcome as the highly intense treatments and thus avoid some long-term side effects?

Monoclonal antibodies: These new treatment options are in the early phases of evaluation. Man-made antibodies that seek out and destroy lymphoma cells have been developed. One of these called rituximab (Rituxan) is being tested in some childhood lymphomas.

Most of these advances are being studied in clinical trials. Your child is always best treated in one of these.

Revised: 03/08/2007