Non-Hodgkin lymphoma

Non-Hodgkin lymphoma is a cancer that starts in the lymphatic system.

It is not the same as Hodgkin lymphoma and is treated differently. See our Hodgkin lymphoma page for more information about this.

The lymphatic system

The lymphatic system is part of the immune system. It consists of the spleen and bone marrow (amongst other things) and is connected by lots of vessels that are joined together by lymph glands (also known as lymph nodes).

The lymphatic system helps your child fight against disease and infection. That is why, when they have a virus, you may have noticed that the lymph nodes under their armpits or in their neck or groin become swollen.

Types of non-Hodgkin lymphoma
Who does it affect?
What are the symptoms?
How is it diagnosed?
How is it treated?
What are the treatment side effects?
After treatment

Types of non-Hodgkin lymphoma

Non-Hodgkin lymphoma can be divided into two types:

  • B-cell non-Hodgkin lymphoma, which usually occurs in the neck, head and abdomen
  • T-cell non-Hodgkin lymphoma, which usually occurs in the chest.

Who does it affect?

Non-Hodgkin lymphoma can affect people of all ages. It is slightly more common in males, accounting for 8% of all cancer diagnoses amongst young men aged 15 to 24. T-cell non-Hodgkin lymphoma is more common in teenagers and young adults than older people. 

What are the symptoms?

The main symptom of non-Hodgkin lymphoma is normally a swollen lymph gland in your child's neck, chest or under their armpit. This swelling is usually painless but lasts for some time.

If the swelling is in their chest, you may notice that they are having difficulty breathing, or have a cough that doesn’t go away. If the swelling is in your child's abdomen, they may develop abdominal pain, have trouble going to the toilet or have diarrhoea. Other symptoms include weight loss, fevers and tiredness.

How is it diagnosed?

Non-Hodgkin lymphoma is usually diagnosed with a biopsy. This involves removing part of the swollen gland, and examining the cells under a microscope. If the biopsy shows that non-Hodgkin lymphoma is present in the gland, your child will also need scans, X-rays and/or blood tests to help the doctors determine the position and spread of the disease.

How is it treated?

Non-Hodgkin lymphoma is usually treated with chemotherapy, often for a significant period of time. The treatment will depend on the size of the affected area and how much the cancer has spread. It’s best to talk to your specialist or one of the team caring for your child about their specific treatment plan.

When your child is receiving chemotherapy a combination of drugs will be delivered into their bloodstream with the aim of killing the cancer cells. T-cell non-Hodgkin lymphoma is usually treated for two years, B-cell for less. Chemotherapy may also be injected into the fluid around their spinal cord to stop the lymphoma from spreading there.

High-dose chemotherapy with stem cell support may be used if your child's cancer does not respond to chemotherapy or if it returns after the initial treatment. For more information, see our high-dose treatment page.

What are the treatment side effects?

If your child is undergoing chemotherapy, they may experience tiredness, sickness, diarrhoea and temporary hair loss. They will also be at greater risk of infections.

For more information about how side effects can be managed, talk to your specialist or nurses, or see the side effects section of our website.

After treatment

Follow up

After your child's treatment is complete they will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your child's cancer has returned (this is known as a relapse). They will also check that your child's major organs, such as their heart and lungs, are still functioning correctly and haven’t been affected by their cancer treatment.

Long-term follow-up

Once your child's risk of relapse has reduced, ongoing follow-up will focus on looking out for potential long-term side effects of treatment. The risk of this depends on the type of cancer your child had and the treatment they received. A personalised surveillance plan is usually created that outlines the specific long-term follow-up and ongoing investigations that they require.

Many people are at low risk of future health problems but some will have significant ongoing health needs.

Long-term side effects

Some of the treatments for non-Hodgkin lymphoma may affect your child's fertility (their ability to have children later in life). Where possible, your specialists will use drugs that have less chance of causing infertility, but treating their cancer needs to be their top priority. If you have concerns about the long-term effects of your child's cancer treatment, talk to your specialist or nursing team.

If your child's fertility has been affected and they are old enough, they might like to read our guidance about cancer and fertility for teenagers and young adults. Here you can find information about fertility preservation treatment, coming to terms with fertility issues, talking to a partner and other ways of starting a family in the future.

Where next?

Updated November 2017, next review due 2019.

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