CareTalk Blog: Nemours Center for Cancer and Blood Disorders

CareTalk: Blog for Cancer and Blood Disorders

Get insights and inspiration from Nemours’ experts in Hematology/Oncology.

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Lymphoma

Lymphomas are cancers that start in a child's lymphatic system — the part of the body that works with the immune system to help fight infections and diseases.

There are two types of pediatric lymphoma:
  • Non-Hodgkin’s lymphoma (also called NHL, non-Hodgkin’s disease, or just non-Hodgkin’s, for short) is the most common type of pediatric lymphoma. This type of cancer develops when there are too many white blood cells in the lymph nodes, bone marrow, spleen, and other areas. Non-Hodgkin’s lymphoma is usually diagnosed in children between the ages of 7 and 11, but older kids and adults can have it, too.
  • Hodgkin’s lymphoma (also called Hodgkin’s disease) develops when abnormal B cells (called Reed-Sternberg cells) start to form in the lymph nodes, spleen, and other areas of the body. Although associated with progressive swelling in the lymph nodes (or glands), Hodgkin’s lymphoma is often hard to diagnosis because symptoms can seem like the flu. Most kids with Hodgkin’s lymphoma are diagnosed around age 15.
 
Signs and Symptoms of Lymphoma in Children

Each individual child’s symptoms can vary, but common signs and symptoms of pediatric lymphoma may include:

  • swelling (typically where lymph nodes are found such as the neck, chest, abdomen, underarms, and groin areas)
  • fever
  • sore throat
  • bone and joint pain 
  • night sweats
  • fatigue (more tired than usual)
  • sudden and increased weight loss
  • burning and itching skin

IMPORTANT NOTE: These signs and symptoms together or on their own do not automatically mean that a child has lymphoma. Any or all of these could be a sign of something else. And not all need be present to indicate lymphoma or any other kind of cancer.

 
Diagnosing Pediatric Lymphoma

Our pediatric cancer care experts will conduct a complete exam of your child and a medical history evaluation. Other diagnostic tests for pediatric lymphoma may include:

  • X-rays
  • blood and urine tests
  • lymph node biopsy (taking a sample of cells or tissues for examination)
  • CAT scan (which stands for computed tomography) — a painless test that uses a special X-ray machine to take black-and-white pictures of the lungs, heart, blood vessels, airway passages, ribs, and lymph nodes
  • PET scan (which stands for positron emission tomography) — an imaging test that helps doctors see how the organs and tissues inside your child’s body are functioning
  • lumbar puncture (also called a spinal tap – when a thin needle is placed in the lower-back area of the spinal cord so we can take and then examine a sample of spinal fluid)

We know that tests can be scary – for you and your child. Whatever kind of tests your child might need, know that your Nemours pediatric cancer care team will do everything we can to make the experience as comfortable as possible – physically and emotionally. We’ll give sedation or anesthesia as needed and offer support and guidance at every step.

Learn more about what to expect with certain medical tests »

 
Treating Lymphoma in Children

Depending on your child’s age, overall health, extent of the disease, and other factors, pediatric lymphoma treatment may include one or a combination of
the following:

  • chemotherapy
  • radiation therapy   
  • blood or bone marrow transplant (also sometimes called a BMT, BBMT, stem cell transplant, or cord blood transplant)
  • medications/antibiotics
  • blood transfusions
  • surgery
  • antibiotics

At Nemours, we know that getting a cancer diagnosis can be very frightening and overwhelming for your whole family. That’s why Nemours’ board-certified pediatric hematologists-oncologists, specialty nurses, cancer researchers, and other cancer experts are focused on helping not only your child, but your family, too.

From diagnosis to treatment (and beyond) we’ll be here to help guide your family through your lymphoma journey – and to strive and hope, with you, for a better tomorrow.

Blood Test: Complete Blood Count

What It Is

The complete blood count (CBC) is a common blood test that evaluates the three major types of cells in the blood: red blood cells, white blood cells, and platelets.

Why It's Done

A CBC may be ordered as part of a routine checkup, or if your child is feeling more tired than usual, seems to have an infection, or has unexplained bruising or bleeding.

  • Red blood cells: The CBC's measurements of red blood cell (RBC) count, hemoglobin (the oxygen-carrying protein in RBCs), and mean (red) cell volume (MCV) provides information about the RBCs, which carry oxygen from the lungs to the rest of the body. These measurements are usually done to test for anemia, a common condition that occurs when the body has insufficient red blood cells.
  • White blood cells: The white blood cell (WBC) count measures the number of WBCs (also called leukocytes) in the blood. The WBC differential test measures the relative numbers of the different kinds of WBCs in the blood. WBCs, which help the body fight infection, are bigger than red blood cells and there are far fewer of them in the bloodstream. An abnormal WBC count may indicate an infection, inflammation, or other stress in the body. For example, a bacterial infection can cause the WBC count to increase, or decrease, dramatically.
  • Platelets: The smallest blood cells, platelets play an important role in blood clotting and the prevention of bleeding. When a blood vessel is damaged or cut, platelets clump together and plug the hole until the blood clots. If the platelet count is too low, a person can be in danger of bleeding in any part of the body.

The CBC can also test for loss of blood, abnormalities in the production or destruction of blood cells, acute and chronic infections, allergies, and problems with blood clotting.

Preparation

No special preparations are needed. Having your child wear a short-sleeve shirt on the day of the test can make things easier for the technician who will be drawing blood.

The Procedure

Not much blood is drawn in a CBC. A health professional will usually draw the blood from a vein. For an infant, the blood may be obtained by puncturing the heel with a small needle (lancet). If the blood is being drawn from a vein, the skin surface is cleaned with antiseptic, and an elastic band (tourniquet) is placed around the upper arm to apply pressure and cause the veins to swell with blood. A needle is inserted into a vein (usually in the arm inside of the elbow or on the back of the hand) and blood is withdrawn and collected in a vial or syringe.

After the procedure, the elastic band is removed. Once the blood has been collected, the needle is removed and the area is covered with cotton or a bandage to stop the bleeding. Collecting blood for this test will only take a few minutes.

drawing_blood

heel_prick_illustration

What to Expect

Either method (heel sticking or vein withdrawal) of collecting a sample of blood is only temporarily uncomfortable and can feel like a quick pinprick. Afterward, there may be some mild bruising, which should go away in a few days.

Getting the Results

The blood sample will be processed by a machine. Parts of the CBC results can be available in minutes in an emergency, but more commonly the full test results come after a few hours or the next day.

If a CBC test points to anemia, infection, or other concerns, your child's doctor may repeat the test just to be sure. If the second set of test results come back the same, your doctor will likely order further lab tests for your child to determine what's causing the problem and how to treat it.

Risks

The CBC test is considered a safe procedure. However, as with many medical tests, there are some problems that can occur with having blood drawn, such as:

  • fainting or feeling lightheaded
  • hematoma (blood accumulating under the skin causing a lump or a bruise)
  • pain associated with multiple punctures to locate a vein

Helping Your Child

Having a blood test is relatively painless. Still, many kids are afraid of needles. Explaining the test in terms your child can understand might help ease some of the fear.

Allow your child to ask the technician any questions he or she might have. Tell your child to try to relax and stay still during the procedure, as tensing muscles and moving can make it harder and more painful to draw blood. It also may help if your child looks away when the needle is being inserted into the skin.

If You Have Questions

If you have questions about the CBC test, contact your doctor.

Reviewed by: Steven Dowshen, MD
Date reviewed: February 2011