Treating Hodgkin Lymphoma in Children

Treating Hodgkin lymphoma in children is slightly different than treating it in adults.

For both children and adults, the main goal of treatment is to cure the lymphoma without causing long-term problems. But doctors adjust treatment based on a child’s age, the extent of their lymphoma, how well the lymphoma is responding to treatment, and other factors.

How are children treated for Hodgkin lymphoma?

• Teenagers who are fully grown: If a child is past puberty and their muscles and bones are fully developed, treatment is usually the same as for adults.
• Children who are still growing: If a child hasn’t reached their full body size, chemotherapy (chemo) will likely be favored over radiation therapy. This is because radiation can affect bone and muscle growth and keep children from reaching their normal size.

If radiation therapy is used, the dose and area treated are kept as small as possible. If a girl or young woman needs radiation on the lower part of her body, her ovaries should be protected to help preserve her fertility.

Children’s bodies tend to tolerate chemotherapy better in the short term than adults. But some side effects are more likely to happen in children. Some of these side effects could be long-term or might not happen until years later, so children who survive cancer need careful attention for the rest of their lives.

Treating classic Hodgkin lymphoma (cHL) in children

For children with classic Hodgkin lymphoma (cHL), chemo is typically the main treatment. Low doses of radiation might also be part of treatment, but doctors try to avoid giving it to children when possible.

The chemo regimens used for children often include combinations of more drugs than are used in adults. This is especially true for lymphomas that have unfavorable features or are more advanced.

In some situations, an immunotherapy drug such as brentuximab vedotin (Adcetris) or nivolumab (Opdivo) might be included as well.

This approach has had excellent success rates, even for children with more advanced disease.

Treating nodular lymphocyte-predominant Hodgkin lymphoma in children

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is very rare in children. There's no single best treatment, and treatments used are often much like those used to treat cHL in children and/or to treat adult NLPHL.

There is one exception. In the early stages of NLPHL in children, surgery to remove the affected lymph node may be the only treatment needed. After surgery, the child is watched closely for signs of lymphoma. Chemo can be used if it comes back.

Where do children go for Hodgkin lymphoma treatment?

Since the 1960s, most children and teens with cancer have been treated at special centers designed for them. Since then, we have learned more about treating childhood cancer, and it has become even more important for children to be treated by experts in this area.

Most children in the United States are treated at a center that is a member of the Children’s Oncology Group (COG). All of these centers are associated with a university or children’s hospital.

These centers offer the advantage of having a team of specialists who are experienced with the differences between adult and childhood cancers, as well as the unique needs of children and their families.

In these centers, doctors treating children with Hodgkin lymphoma often use treatment that is part of a clinical trial. The purpose of these studies is to find the best treatments that cause the fewest side effects.

You can learn more about this in How to Find the Best Cancer Treatment for Your Child.

Who is part of the treatment team?

This team usually includes pediatric oncologists, surgeons, radiation oncologists, pathologists, pediatric oncology nurses, and nurse practitioners.

Childhood cancer centers also have psychologists, social workers, child life specialists, nutritionists, rehabilitation and physical therapists, and educators who can support your entire family.

Learn more

Any time a child or teen is diagnosed with cancer, it affects every family member and nearly every aspect of the family’s life. You can read more about coping with these changes in Childhood Cancer.