AIDS-Related Lymphoma in Children
What is AIDS-related lymphoma in
children?
AIDS-related lymphoma is a type of cancer called non-Hodgkin
lymphoma
(NHL). Childrenwith
AIDS
have a higher risk forthis
cancer. AIDS is a disease that weakens the immune system. AIDS raises
the risk for
infection and for long-term
(chronic) diseases, such
as cancer.
AIDS-related lymphoma grows in the white blood cells of the lymphatic system. The
lymphatic system is part of the immune system. It helps
fight
diseases and infections. The lymphatic system also
helps balance
fluids in different parts of the body. The lymphatic system includes:
- Lymph.This
is a clear
fluid that contains
white
bloods
cells called
lymphocytes.
- Lymph
vessels. These are tiny tubes that carry lymph fluid
all
over the body.
- Lymphocytes. These are a type of white blood cell that fight infections and disease.
- Lymph
nodes. These are small bean-shaped organs.
They're
scattered
all
over
the
body. They're
connected by lymph vessels.Andthey
filter the lymph fluid as it moves around the body.
- Other organs
and body
tissues.The
lymphatic system includes the bone marrow where blood is made.
It
also
includes the spleen, thymus, tonsils, and digestive tract.
Along
with the lymphatic system, AIDS-related lymphoma
can
affect
the
brain and spinal cord (central nervous
system).
It can also affect
the
lining of body
cavities.
These
include
the
chest,
the
belly
(abdomen),
and
the
sac
containing the
heart.
The
2 main types
of AIDS-related lymphoma are:
- Diffuse large B-cell lymphoma
- Burkitt lymphoma
Both
grow very fast and can grow outside the lymphatic system.
What causes AIDS-related lymphoma in a child?
HIV
is the virus that causes
AIDS. People are often
infected with HIV through contact with the blood or other body fluids
of someone with HIV or AIDS. In children, this
often
happens during pregnancy, labor and delivery, or breastfeeding with a
mother who has HIV or AIDS.
The
HIV virus attacks the body's immune
system.
This makes it harderfor
the immune system to fight cancers and infections. People with AIDS have an increased
chance of
lymphoma
and other types of
cancer. They're
also at a high risk for
infections.
Which children are at risk for AIDS-related lymphoma?
All people with
HIV, no matter
their age,are
at risk forAIDS-related
lymphoma.
What are the symptoms of AIDS-related lymphoma in a child?
Your
child may have many different symptoms. It depends on the type of lymphoma and where itis.
Symptoms may include:
- Swollen, painless lymph nodes in the neck, underarm, or groin
- Trouble breathing
- Loud breathing or wheezing
- Night sweats
- Unexplained weight loss
- Fever with no known reason
- Trouble swallowing
- Swelling in the head or neck
- Swelling and pain in the belly (abdomen)
The symptoms of AIDS-related lymphoma can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.
How is AIDS-related lymphoma diagnosed in a child?
If
your child has
HIV,
he or she will be checked often for
changes.
This
includes
changes
that might be signs of AIDS-related lymphoma. Your child's healthcare provider will ask
about your child's health history and symptoms.
A physical exam
will
be
done. Your
child may need tests
such as:
- Blood and urine tests.Blood and urine samples are tested in a lab.
- Tissue and lymph node
biopsy. Small
tissue samplesare taken
from the lymph nodes or other body tissue. They’re checked with a microscope for
cancer cells.
- Chest
X-ray. This
shows the heart, lungs, and other parts of the chest.
- CT scan.This
uses a series of X-rays and a computer to make detailed pictures of the inside of the
body. Your child may drink a contrast dye or it may be injected into a vein. The dye
helps show more details.
- MRI scan. An MRI uses
large magnets, radio waves, and a computer to make detailed pictures of the inside of
the body. Contrast dye may be injected into your child's vein. It helps show details
more
clearly. This
test is used to check the brain and spinal cord. Or it may be used if the results of
an X-ray or CT
scan are not
clear.
- Ultrasound.
This
is also called sonography. Sound waves and a computer are used to make pictures of
lymph nodes,
blood vessels, tissues, and organs.
- Bone
marrow aspiration or biopsy. Bone marrow is found in the center of
some bones. It’s where blood cells are made. A small amount of bone marrow fluid canbe
taken
out. This is called aspiration. Or solid bone marrow tissue may be
taken. This is called a core biopsy. Bone marrow
is often
taken from the
back of the
hip bone. This test may be done to see if cancer cells have reached
the bone marrow.
- Lumbar
puncture
(spinal tap). A thin
needle
is placed
between
the bones in
the lower
back andinto the
spinal canal. This is the area around the spinal cord. This is done to
see if there
are
cancer
cells in
the brain and spinal
cord.
A small amount of cerebral spinal fluid (CSF) is
taken out
and
sent for testing. CSF is the fluid around the brain and spinal cord.
- Pleural or peritoneal
fluid sampling. Fluid is removed from around the lungsor
the
belly.
The fluid is checked for cancer cells.
Part
of diagnosing cancer is called staging. Staging is the process of seeing if the cancer
has spread, and where it has spread. Staging also helps to decide
on
the
best
treatment
options. There are different
staging
systems
used for NHL.But
most range from stage 1 to stage
4.
Stage
4 is cancer that has spread to parts of the body that are not
part
of
the lymphatic system.
Talk
with your child's healthcare provider about the stage of your child's
cancer and what
it means.
How
is AIDS-related lymphoma treated in a child?
Treatment will depend on the type and stage of lymphoma. It will also depend on:
- When your child first
had
treatment for HIV/AIDS
- If the cancer has spread to the brain or spinal cord
- If
there are
gene
changes in
the cancer cells
Treatment may include any of the below:
- Chemotherapy
(chemo). These are medicines that kill cancer cells
or stop them from growing.
This
is
the main treatment for
lymphoma.
- Radiation
therapy. These are high-energy X-rays or other types of radiationused to kill cancer cells.This
treatment
may be used if lymphoma has spread to the
CSF.
Or
it
may be used
to
treat tumors that are causing
problems
such
as
pressing on nerves or breathing tubes.
- Monoclonal
antibodies. This
is a type of targeted therapy
that's made
to focus on and kill the cancer
cells. It causes littleharm
to healthy cells.
- High-dose chemotherapy
with a stem cell transplant. Young blood cells (stem cells) are taken
from the child or from someone else. This is followed by
high
doses
of chemotherapy.This
causes
bone
marrow
damage. After the chemotherapy, the stem cells are replaced.
- Supportive care.Treatment
can cause side
effects.
Supportive care is
medicine
and other
treatments
used for pain, fever, infection, and
nausea and vomiting.
- Clinical
trials. Ask your child's healthcare provider if there are any treatments being tested
that may work well for your
child. Many
new treatments are only available in clinical trials.
Treating the HIV infection itself is also an important part of therapy. Your child will be given antiretroviral treatment (ART) to control the virus.
Your child will need follow-up care during and after treatment to:
- Check on your child's response to the treatment
- Manage the side effects of treatment
- See if cancer
has
returned
or spread
- Keep
the HIV under control
What are
the
possible complications of AIDS-related lymphoma in a child?
Possible complications depend on the type and stage of the lymphoma,
as well as the
treatments
used. Complications
can include:
- Increased risk of infection
- Easy
bleeding and bruising
- Heart disease
- Lung problems
- Increased chance of growing other cancers
- Trouble
having
a baby (infertility)
- Nausea and vomiting
- Diarrhea
- Poor appetite
- Sores in the mouth
- Hair loss
Talk withyour
child's healthcare
provider
about what you should watch
for.
Also
ask
what can be done to help prevent complications.
How
can I help my child
live with
AIDS-related
lymphoma?
You can help your child manage his or her treatment in many ways. For example:
- Your child may have trouble eating. A dietitian may be able to help.
- Your child may be very tired. He or she will need to balance rest and activity. Encourage your child to get some exercise. This is good for overall health. And it may help to lessen tiredness.
- Get
emotional support for your child. Find a counselor or
a
child support group
that
can help.
- Make
sure your child
goes
to all follow-up appointments.
When should I call my child’s healthcare provider?
Call the healthcare provider if your child has:
- Symptoms that get worse
- New symptoms
- Side effects from treatment
Key points about AIDS-related lymphoma in a child
- AIDS-related lymphoma a type of non-Hodgkin lymphoma.
- It may affect the lymphatic system, brain and spinal cord, and other parts of the body.
- Treatment depends on the type, stage, and other factors. It may include chemotherapy, radiation therapy, and stem-cell transplant.
- Treating the HIV is an important of your child's health.
Next steps
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why
a new medicine or treatment is prescribed and how it will help your child. Also know
what
the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know
how you can contact your child’s provider after office
hours.
This is important if
your
child becomes ill and you have questions or need advice.
Online Medical Reviewer:
Kim Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer:
Lu Cunningham
Date Last Reviewed:
9/1/2018
© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.