Chemotherapy for Hodgkin Lymphoma in Children

Chemotherapy, which shrinks tumors by destroying cancer cells, is the first-line treatment for childhood Hodgkin lymphoma. Pediatric oncologists at NYU Langone’s Stephen D. Hassenfeld Children’s Center for Cancer and Blood Disorders typically treat children, adolescents, and young adults who have Hodgkin lymphoma with cycles of outpatient chemotherapy. Each cycle includes one to three days of chemotherapy per week, followed by a one-week rest period to give the body time to recover.

Early Hodgkin lymphoma may require only two to four cycles of chemotherapy; more advanced Hodgkin lymphoma may require up to eight cycles.

Traditionally, the most common combination of chemotherapy drugs used to treat childhood Hodgkin lymphoma is ABVD—Adriamycin® (doxorubicin), bleomycin, vinblastine, and dacarbazine. But most children now receive newer combinations of drugs that are used to improve the response to treatment and to diminish long-term side effects.

Managing Side Effects

Chemotherapy is designed to attack cells that divide quickly, so it affects not only cancer cells but also healthy cells in the bone marrow, hair follicles, the immune system, the intestines, and the mouth. This can lead to side effects that may include constipation or diarrhea, fatigue, flu-like symptoms, mouth sores, nausea, numbness in the hands and feet, stomach pain, and vomiting.

Also, children undergoing chemotherapy may develop neutropenia, a condition marked by an unusually low number of white blood cells. Neutropenia can increase the risk of infection, but it can be treated with a medication that boosts white blood cells. These side effects tend to be temporary and often go away after therapy is completed. 

Hair loss frequently begins three to four weeks after the first round of chemotherapy for Hodgkin lymphoma. For some children, this can be even more upsetting than the diagnosis or the treatment. NYU Langone oncology nurses, social workers, child psychologists, and child life specialists help your child live through the emotional stress of hair loss and recommend bandanas, hats, scarves, and wigs until the hair grows back weeks or months after chemotherapy is completed. 

Teen and young adult support groups at Stephen D. Hassenfeld Children’s Center for Cancer and Blood Disorders can help older children cope with Hodgkin lymphoma.

Our doctors focus on preventing or diminishing long-term side effects. The team makes every effort to preserve Hodgkin lymphoma’s high cure rates while lessening the risk of damage to healthy organs, such as the heart and lungs. 

Some treatments for childhood Hodgkin lymphoma can cause infertility in boys and girls. Our specialists talk to you about the risk of infertility based on the treatment your child is receiving and options for banking sperm or freezing eggs before starting treatment.

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