Update on lymphoma

Lymphoma comprises ∼10% of childhood cancers and 17% of cancer in teenagers. It is divided into Hodgkin and non-Hodgkin lymphoma; most of the latter in children are Burkitt lymphoma, lymphoblastic lymphoma and anaplastic large cell lymphoma. Lymphoma commonly presents with painless lymphadenopathy, usually cervical. ‘B’ symptoms are associated with advanced disease. The diagnosis is made by histological examination of an excised lymph node, but can be made on pleural fluid or a bone marrow aspirate. Emergency management, particularly of the airway, may be necessary, particularly in non-Hodgkin lymphoma. Lymphomas are treated with multi-drug chemotherapy regimens, stratified by risk group, with radiotherapy in selected cases. In Hodgkin lymphoma, PET is prognostic after two cycles of chemotherapy. The high cure rate for lymphomas (greater than 90% for Hodgkin and Burkitt lymphoma) and the need to reduce late effects has led to the drive to tailor treatment according to risk groups and response to initial therapy.