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Fortunately, cancer cases in adolescents and children are quite rare even though there has been a slight increase of the overall cases of childhood cancer since 1975. It is important that children and adolescents suffering from cancer are referred to medical facilities that have teams of multi-disciplinary cancer specialists and who are well experienced about treatment of these types of cancers.The multi- disciplinary team is one that incorporates all the necessary skills of primary care physicians, radiation oncologists, pediatric surgical subspecialists, pediatric medical hematologists/ oncologists, social workers, rehabilitation specialists and others. Such a team will help ensure that the patients get the treatment they need; rehabilitation and supportive care that will make them survive and lead a quality life.

Epidemiology of Lymphoma

Lymphoma is regarded as the third in line among the most common malignancy found in children. NHL itself accounts for about 7 percent of children cancers for those aged below 20 years. About 800 new NHL cases are diagnosed in the United States each year. This translates to about 10 cases per a million people in US per year. NHL incidence as observed in both children and adolescents tend to vary considerably depending on the age, gender, histology and race. Even though sharp age peak doesn’t exist as such, children below 3 years are more affected by lymphoma. Cases of NHL among infants are very rare. Nevertheless, incidences of NHL have been increasing considerably especially for those aged between 15 and 19 years. However, cases of NHL among children below 15 years have remained constant for the past couple of decades.

Childhood NHL: Prognostic factors

Thanks to the current treatments available, over 80 percent of adolescents and young children with NHL are going to survive to at least five years. However, the outcome of the treatment is variable and depends on a couple of factors, including histology and clinical stage. Age is one of the factors. Cases of NHL are rare in infants and compared to the younger children, the outcome of adolescents is relatively inferior.

The site of the diseases also matters a lot. Generally speaking, patients having a low stage disease have excellent prognosis and their chance of surviving is incredibly high. Another prognostic factor is chromosomal abnormality. Even though the data available for cytogenetics is relatively less robust compared with childhood leukemia, there are certain chromosomal abnormalities with prognostic value as well.

The tumor burden has also been shown to come with its share of prognostic value in many studies. Recently, minimal disease detection at diagnosis can be prognostic for many types of childhood NHL. However, doctors are yet to ascertain the prognostic role that MRD plays in the treatment. The final prognostic factor is response to therapy. A very critical predictive factor for leukemia is how the disease responds to the initial treatment.