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 health and specific information about the lymphoma. Treatments are based on the stage of the cancer.

The main treatment for newly diagnosed childhood lymphoblastic lymphoma involves chemotherapy. Chemotherapy may be given in 3 or more phases, including induction, consolidation and maintenance.

Chemotherapy is the main treatment for childhood lymphoblastic lymphoma. How long chemotherapy is given depends on the stage, risk group and treatment plan (protocol).

The induction and consolidation phases include combinations of many different chemotherapy drugs. Intrathecal chemotherapy is given directly into the cerebrospinal fluid (CSF). It may be given in the first 2 phases or at different times throughout the entire treatment to prevent cancer cells from spreading to the brain and spinal cord (called the central nervous system, or CNS). These treatments are then followed by maintenance therapy. It usually takes 2 years to complete all 3 phases of treatment.

Chemotherapy drugs are given in different combinations based on different treatment plans. The most common chemotherapy drugs used in combination for the induction and consolidation phases to treat lymphoblastic lymphoma are:

• prednisone
• dexamethasone (Decadron, Dexasone)
• vincristine (Oncovin)
• daunorubicin (Cerubidine, daunomycin)
• doxorubicin (Adriamycin)
• asparaginase (Kidrolase)
• cyclophosphamide (Procytox)
• cytarabine (Cytosar)
• methotrexate
• mercaptopurine (Purinethol)
• thioguanine (Lanvis)
• carmustine (BiCNU, BCNU)
• leucovorin (folinic acid)

The chemotherapy drug used for intrathecal chemotherapy is usually methotrexate.

Maintenance chemotherapy usually includes daily mercaptopurine, weekly oral methotrexate, monthly vincristine, short courses of steroids and intrathecal chemotherapy.

If there is evidence of lymphoma in the cerebrospinal fluid (spinal fluid) at diagnosis, children with lymphoblastic lymphoma may receive cranial radiation in addition to intrathecal chemotherapy.

Treatments for recurrent (relapsed) childhood lymphoblastic lymphoma usually include intense chemotherapy to get the child into remission and then an allogeneic stem cell transplant. Children with recurrent childhood lymphoblastic lymphoma may be enrolled in a clinical trial.

Chemotherapy combinations used for recurrent childhood lymphoblastic lymphoma may include:

• ifosfamide (Ifex), carboplatin (Paraplatin, Paraplatin AQ) and etoposide followed by a stem cell transplant
• nelarabine (Atriance)–based chemotherapy followed by a stem cell transplant

Children with cancer may be treated in a clinical trial. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.