Causes, Risk Factors, and Prevention of Lymphoma in Children

The immune system normally works to fight off infections and keep the body healthy. For people with some immunodeficiency syndromes, the immune system doesn’t work properly, so they are more likely to get serious infections.

Lymphomas and some other cancers may be seen in children and teens with these syndromes, including:

• Wiskott-Aldrich syndrome (WAS)
• Nijmegen breakage syndrome
• Ataxia-telangiectasia
• Common variable immunodeficiency (CVID)
• X-linked lymphoproliferative syndrome (XLP)
• Autoimmune lymphoproliferative syndrome (ALPS)

Children with autoimmune diseases such as rheumatoid arthritis, Sjögren’s syndrome, and lupus (SLE) may also be at higher risk for developing lymphoma.

This may happen because their immune system doesn’t work correctly or because of medications they take to treat the disease. It might also be a combination of both.

Most children who develop lymphoma have no family history, but it may play a role in some cases.

• Hodgkin lymphoma: People who have a sibling with Hodgkin lymphoma, especially an identical twin, are at increased risk for developing the disease.
• Non-Hodgkin lymphoma: Some research suggests family history may also be linked to certain non-Hodgkin lymphomas.

The reason for this is not well known. Researchers think it may be caused by common inherited genes, similar exposures to infections, or a combination of the two.

A few types of infections have been associated with lymphoma.

Epstein-Barr virus (mononucleosis or mono)

Epstein-Barr virus (EBV) is a very common infection in children and teens. It is often called mononucleosis or mono. This infection doesn’t usually cause long-term problems, but people who’ve had it are at higher risk of certain types of lymphoma.

In areas of Africa where Burkitt lymphoma is common, chronic infection with both malaria and the Epstein-Barr virus is an important risk factor. EBV has been linked with almost all Burkitt lymphomas in Africa. In the United States, EBV has been linked with about 15% of Burkitt lymphomas.

EBV is also linked to:

• Hodgkin lymphoma
• Many lymphomas that happen after an organ transplant

Human immunodeficiency virus (HIV)

Infection with HIV, the virus that causes AIDS, can weaken the immune system. Because HIV is a risk factor for certain types of lymphoma, doctors may recommend children with lymphoma be tested for HIV infection.

Children who take medicines that affect how the immune system works can be at a higher risk of lymphoma. A child might be on immune system suppressing drugs to treat an autoimmune condition or to prevent their body from rejecting bone marrow or an organ after a transplant.

While rare, lymphomas are a serious potential risk of these types of medicines.

Radiation exposure may be a minor risk factor for non-Hodgkin lymphoma (NHL).

Accidental radiation exposure

Survivors of atomic bomb exposures and nuclear reactor accidents have an increased risk of developing some types of cancer. Leukemia and thyroid cancer are the most common, but there is a slightly increased risk of NHL as well.

Radiation therapy

People treated with radiation therapy for other cancers have a slightly increased risk of NHL later in life. It usually takes many years for this to develop, so these secondary cases of NHL are more common in adults than in children.

X-rays and CT scans

Children may be exposed to lower levels of radiation from x-ray tests and CT scans. Doctors don’t fully know if this increases the risk of lymphoma.

If these tests increase the risk for lymphoma or other cancers, the increase is likely to be small. But to be safe, most doctors recommend children and people who are pregnant avoid these tests unless they are absolutely needed.