Treatments for childhood lymphoblastic lymphoma
The following are treatment options for childhood lymphoblastic lymphoma. The healthcare team will suggest treatments based on your child’s needs and work with you to develop a treatment plan. Treatments are based on the stage of the cancer.
First-line therapy for childhood lymphoblastic lymphoma
First-line therapy is the first or most common treatment used. The following may be used as first-line therapy for childhood lymphoblastic lymphoma.
Chemotherapy is the main treatment for childhood lymphoblastic lymphoma.
It can be given in 3 phases: induction, consolidation and maintenance. The induction and consolidation phases can include combinations of many different chemotherapy drugs. Intrathecal chemotherapy, or chemotherapy given directly into the cerebrospinal fluid (CSF), may also be given in the first 2 phases to prevent cancer cells from spreading to the brain and spinal cord (called the central nervous system, or CNS). These treatments are followed by maintenance therapy. It usually takes 2–3 years to complete all 3 phases of treatment.
Chemotherapy drugs are given in different combinations based on different treatment plans (called protocols). The most common chemotherapy drugs used in combinations for lymphoblastic lymphoma are:
- dexamethasone (Decadron, Dexasone)
- vincristine (Oncovin)
- daunorubicin (Cerubidine, daunomycin)
- doxorubicin (Adriamycin)
- L-asparaginase (Kidrolase)
- cyclophosphamide (Cytoxan, Procytox)
- cytarabine (Cytosar, Ara-C)
- mercaptopurine (Purinethol, 6-MP)
- thioguanine (Lanvis, 6-TG)
- carmustine (BiCNU, BCNU)
- leucovorin (folinic acid)
The chemotherapy drug used for intrathecal chemotherapy is usually methotrexate, but may include other drugs for children with cancer that has spread to the central nervous system (CNS).
Maintenance chemotherapy usually includes daily mercaptopurine, weekly oral methotrexate, monthly vincristine and short courses of steroids.
In some cases, radiation therapy may be given to the head if the cancer has spread to the brain and spinal cord.
Recurrent childhood lymphoblastic lymphoma
Treatments for recurrent, or relapsed, childhood lymphoblastic lymphoma may include more intense chemotherapy or an allogeneic stem cell transplant.
Some chemotherapy combinations used for recurrent childhood lymphoblastic lymphoma include:
- dexamethasone, etoposide (Vepesid, VP-16), cisplatin (Platinol AQ), cytarabine and asparaginase
- ifosfamide (Ifex), carboplatin (Paraplatin, Paraplatin AQ) and etoposide
Many children with childhood lymphoblastic lymphoma will be treated in a clinical trial that is tailored to the risk group or stage of their disease. The clinical trial protocol, or plan, outlines the treatments used (such as chemotherapy), as well as the drugs and dosages used. Find out more about clinical trials.