Non-Hodgkin Lymphoma Treatment

Childhood non-Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system, which is a part of the body's immune system.

The immune system helps protect the body from infection and disease.

The lymph system is made up of the following:

• Lymph: Incoloro, acuoso líquido que viaja a través de la vasos linfaticos and carries linfocitos (white blood cells).
  • B lymphocytes, also called B cells, make antibodies to help fight infection. Most types of non-Hodgkin lymphoma begin in B lymphocytes.
  • T lymphocytes, also called T cells, help B lymphocytes make the antibodies that help fight infection.
  • Natural killer cells, also called NK cells, attack cancer cells and viruses.
• Lymph vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.
• Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are found along a network of lymph vessels throughout the body. Groups of lymph nodes are found in the neck, underarm, mediastinum (the area between the lungs), abdomen, pelvis, and groin.
• Spleen: An organ that makes lymphocytes, stores red blood cells and lymphocytes, filters the blood, and destroys old blood cells. The spleen is on the left side of the abdomen near the stomach.
• Thymus: An organ in which T lymphocytes mature and multiply. The thymus is in the chest behind the breastbone.
• Amígdalas: Dos pequeñas masas de tejido linfático en la parte posterior de la garganta . Hay una amígdala a cada lado de la garganta.
• Bone marrow: The soft, spongy tissue in the center of certain bones, such as the hip bone and breastbone. White blood cells, red blood cells, and platelets are made in the bone marrow.

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The lymph system is part of the body's immune system and is made up of tissues and organs that help protect the body from infection and disease. These include the tonsils, thymus, spleen, bone marrow, lymph vessels, and lymph nodes. Lymph (clear, watery fluid) and lymphocytes (white blood cells) travel through the lymph vessels and into the lymph nodes where the lymphocytes destroy harmful substances. The lymph enters the bloodstream through a large vein near the heart.

Lymph tissue is also found in other parts of the body such as the stomach, thyroid gland, brain, and skin.

Non-Hodgkin lymphoma can begin in B lymphocytes, T lymphocytes, or natural killer cells.

There are two general types of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphoma. This summary is about the treatment of childhood non-Hodgkin lymphoma. For information about the treatment of childhood Hodgkin lymphoma, see Childhood Hodgkin Lymphoma Treatment.

Treatment of non-Hodgkin lymphoma is different for children and adults. For information about treatment of adults, see the following:

• Adult Non-Hodgkin Lymphoma
• Tratamiento del linfoma primario del SNC
• Mycosis Fungoides (Including Sezary Syndrome) Treatment

There are three major types of childhood non-Hodgkin lymphoma.

The type of lymphoma is determined by how the cells look under a microscope. The three major types of childhood non-Hodgkin lymphoma are:

Some types of non-Hodgkin lymphoma are rare in children.

Some types of childhood non-Hodgkin lymphoma are less common. These include:

• Pediatric-type follicular lymphoma: In children, follicular lymphoma occurs mainly in males. It is more likely to be found in one area and does not spread to other places in the body. It usually forms in the tonsils and lymph nodes in the neck, but may also form in the testicles, kidney, gastrointestinal tract, and salivary gland.
• Marginal zone lymphoma: Marginal zone lymphoma is a type of lymphoma that tends to grow and spread slowly and is usually found at an early stage. It may be found in the lymph nodes or in areas outside the lymph nodes. Marginal zone lymphoma found outside the lymph nodes in children is called mucosa-associated lymphoid tissue (MALT) lymphoma. MALT may be linked to Helicobacter pylori infection of the gastrointestinal tract and Chlamydophila psittaci infection of the conjunctival membrane which lines the eye. Marginal zone lymphoma is rare in children but common in adults.
• Primary central nervous system (CNS) lymphoma: Primary CNS lymphoma is extremely rare in children.
• Peripheral T-cell lymphoma: Peripheral T-cell lymphoma is an aggressive (fast-growing) non-Hodgkin lymphoma that begins in mature T lymphocytes. Other types of peripheral T-cell lymphoma include mature T-cell/natural killer-cell lymphoma, extranodal NK/T-cell lymphoma, and gamma-delta hepatosplenic T-cell lymphoma. Peripheral T-cell lymphoma is rare in children.
• Cutaneous T-cell lymphoma: Cutaneous T-cell lymphoma begins in the skin and can cause the skin to thicken or form a tumor. It is very rare in children but is more common in adolescents and young adults. There are different types of cutaneous T-cell lymphoma, such as cutaneous anaplastic large cell lymphoma, subcutaneous panniculitis-like T-cell lymphoma, gamma-delta T-cell lymphoma, and mycosis fungoides. Mycosis fungoides rarely occurs in children and adolescents.

Having a weakened immune system increases the risk of NHL in children.

Anything that increases a person's risk of getting a disease is called a risk factor. Not every child with one or more of these risk factors will develop NHL, and it will develop in some children who don't have any known risk factors. Talk with your child's doctor if you think your child may be at risk.

Some of the types of immune system problems that have been linked with a higher risk of childhood NHL include the following:

• Being infected with the Epstein-Barr virus or human immunodeficiency virus (HIV).
• Having a weakened immune system after a transplant or from medicines given after a transplant.
• Having certain inherited diseases (such as DNA repair defect syndromes which include ataxia-telangiectasia, Nijmegen breakage syndrome, and constitutional mismatch repair deficiency).
• Past treatment for cancer.

If lymphoma or lymphoproliferative disease is linked to a weakened immune system from certain inherited diseases, HIV infection, a transplant or medicines given after a transplant, the condition is called lymphoproliferative disease associated with immunodeficiency. The different types of lymphoproliferative disease associated with immunodeficiency include:

• Lymphoproliferative disease associated with primary immunodeficiency.
• HIV-associated non-Hodgkin lymphoma.
• Post-transplant lymphoproliferative disease.
• Lymphoproliferative disease from chemotherapy.

Signs of childhood non-Hodgkin lymphoma include breathing problems and swollen lymph nodes.

These and other signs may be caused by childhood non-Hodgkin lymphoma or by other conditions. Check with a doctor if your child has any of the following:

• Dificultad para respirar.
• Wheezing.
• Coughing.
• High-pitched breathing sounds.
• Swelling of the head, neck, upper body, or arms.
• Dificultad al tragar.
• Painless swelling of the lymph nodes in the neck, underarm, stomach, or groin.
• Painless lump or swelling in a testicle.
• Fever for no known reason.
• Weight loss for no known reason.
• Drenching night sweats.
• Pain or swelling in the abdomen.

Tests that examine the body and lymph system are used to diagnose childhood non-Hodgkin lymphoma.

In addition to asking about your child's personal and family health history and doing a physical exam, your child's doctor may perform the following tests and procedures:

• Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body, including electrolytes, lactate dehydrogenase (LDH), uric acid, blood urea nitrogen (BUN), creatinine, and liver function values. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
• Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher-than-normal amount of a substance can be a sign of cancer.
• Tomografía computarizada (TC): A procedure that makes a series of detailed pictures of areas inside the body, such as the neck, chest, abdomen, and pelvis, taken from different angles. The pictures are made by a computer linked to an rayos X máquina. A teñir tal vez inyectado en una vena or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
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  Computed tomography (CT) scan. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body.
  

• Exploración PET (tomografía por emisión de positrones):Un procedimiento para encontrar maligno células tumorales en el cuerpo. Una pequena cantidad de material radioactivo glucosa (azúcar) se inyecta en una vena. La mascota escáner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Sometimes a PET scan and a CT scan are done at the same time. If there is any cancer, this increases the chance that it will be found.
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  Positron emission tomography (PET) scan. The child lies on a table that slides through the PET scanner. The head rest and white strap help the child lie still. A small amount of radioactive glucose (sugar) is injected into the child's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.
  

• Resonancia magnética: Un procedimiento que utiliza un imán, ondas de radio, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
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  Magnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.
  

• Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that the cancer has spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.
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  Lumbar puncture. A patient lies in a curled position on a table. After a small area on the lower back is numbed, a spinal needle (a long, thin needle) is inserted into the lower part of the spinal column to remove cerebrospinal fluid (CSF, shown in blue). The fluid may be sent to a laboratory for testing.
  

• Radiografía de tórax: consiste en una radiografía de los órganos y huesos del interior del tórax. Un rayo X es un tipo de haz de energía que puede atravesar el cuerpo y plasmarse en una película, generando una imagen de áreas internas del cuerpo.
• examen de ultrasonido: procedimiento en el que se hacen rebotar ondas sonoras de alta energía (ultrasonido) en los tejidos u órganos internos y se generan ecos. Los ecos forman una imagen de los tejidos del cuerpo llamada sonograma.
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  Ultrasonido abdominal. Un transductor de ultrasonido conectado a una computadora se presiona contra la piel del abdomen. El transductor hace rebotar ondas de sonido en los órganos y tejidos internos para producir ecos que forman un sonograma (imagen de computadora).
  

A biopsy is done to diagnose childhood non-Hodgkin lymphoma.

Cells and tissues are removed during a biopsy so they can be viewed under a microscope by a pathologist to check for cancer cells. Because treatment depends on the type of non-Hodgkin lymphoma, biopsy samples should be checked by a pathologist who has experience in diagnosing childhood non-Hodgkin lymphoma.

One of the following types of biopsies may be done:

• Excisional biopsy: The removal of an entire lymph node or lump of tissue.
• Incisional biopsy: The removal of part of a lump, lymph node, or sample of tissue.
• Core needle biopsy: The removal of tissue or part of a lymph node using a wide needle.
• Fine-needle aspiration (FNA) biopsy: The removal of tissue or part of a lymph node using a thin needle.

The procedure used to remove the sample of tissue depends on where the tumor is in the body:

• Bone marrow aspiration and biopsy: The removal of bone marrow and a small piece of bone by inserting a hollow needle into the hipbone or breastbone.
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  Bone marrow aspiration and biopsy. After a small area of skin is numbed, a bone marrow needle is inserted into the child’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.
  

• Mediastinoscopy: A surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It also has a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.
• Anterior mediastinotomy: A surgical procedure to look at the organs and tissues between the lungs and between the breastbone and heart for abnormal areas. An incision (cut) is made next to the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It also has a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. This is also called the Chamberlain procedure.
• Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

Si se encuentra cáncer, se pueden realizar las siguientes pruebas para estudiar las células cancerosas:

• Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
• Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of the cells, such as size, shape, and the presence of tumor (or other) markers on the cell surface. The cells from a sample of a patient’s blood, bone marrow, or other tissue are stained with a fluorescent dye, placed in a fluid, and then passed one at a time through a beam of light. The test results are based on how the cells that were stained with the fluorescent dye react to the beam of light. This test is used to help diagnose and manage certain types of cancers, such as leukemia and lymphoma.
• Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of blood or bone marrow are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
• FISH (fluorescence in situ hybridization): A laboratory test used to look at and count genes or chromosomes in cells and tissues. Pieces of DNA that contain fluorescent dyes are made in the laboratory and added to a sample of a patient’s cells or tissues. When these dyed pieces of DNA attach to certain genes or areas of chromosomes in the sample, they light up when viewed under a fluorescent microscope. The FISH test is used to help diagnose cancer and help plan treatment.
• Inmunofenotipado: prueba de laboratorio que utiliza anticuerpos para identificar células cancerosas según los tipos de antígenos o marcadores en la superficie de las células. Esta prueba se utiliza para ayudar a diagnosticar tipos específicos de linfoma.

Existen factores que influyen en el pronóstico (es decir, la posibilidad de recuperación) y en las opciones de tratamiento disponibles.

El pronóstico y las opciones de tratamiento dependen de:

• The type of lymphoma.
• Where the tumor is in the body when the tumor is diagnosed.
• La etapa del cáncer.
• Whether there are certain changes in the chromosomes.
• The type of initial treatment.
• Whether the lymphoma responded to initial treatment.
• The patient’s age and general health.

After childhood non-Hodgkin lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body.

The process used to find out if cancer has spread within the lymph system or to other parts of the body is called staging. The results of tests and procedures used to diagnose non-Hodgkin lymphoma may also be used for staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

For a description of the tests and procedures used to diagnose non-Hodgkin lymphoma, see General Information.

Hay tres formas en que el cáncer puede propagarse por el cuerpo.

El cáncer se puede propagar a través de los tejidos, el sistema linfático y la sangre:

• Tejidos: el cáncer se propaga desde el lugar donde comenzó y crece hacia las áreas circundantes.
• Sistema linfático: el cáncer se propaga desde el lugar donde comenzó hacia el sistema linfático. El cáncer viaja a través de los vasos linfáticos a otras partes del cuerpo.
• Sangre: el cáncer se propaga desde el lugar donde comenzó hacia la sangre. El cáncer viaja a través de los vasos sanguíneos a otras partes del cuerpo.

The following stages are used for childhood non-Hodgkin lymphoma:

Estadio 1

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Stage I childhood non-Hodgkin lymphoma. Cancer is found in one group of lymph nodes or one area outside the lymph nodes, but no cancer is found in the abdomen or mediastinum (area between the lungs).

In stage I childhood non-Hodgkin lymphoma, cancer is found:

• in one group of lymph nodes; or
• in one area outside the lymph nodes.

No cancer is found in the abdomen or mediastinum (area between the lungs).

Estadio 2

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Stage II childhood non-Hodgkin lymphoma. Cancer is found in one area outside the lymph nodes and in nearby lymph nodes (a); or in two or more areas above (b) or below (c) the diaphragm; or cancer started in the stomach, appendix, or intestines (d) and can be removed by surgery.

In stage II childhood non-Hodgkin lymphoma, cancer is found:

• in one area outside the lymph nodes and in nearby lymph nodes; or
• in two or more areas either above or below the diaphragm, and may have spread to nearby lymph nodes; or
• to have started in the stomach or intestines and can be completely removed by surgery. Cancer may have spread to certain nearby lymph nodes.

Estadio 3

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Stage III childhood non-Hodgkin lymphoma. Cancer is found in at least one area above and below the diaphragm (a); or cancer started in the chest (b); or cancer started in the abdomen and spread throughout the abdomen (c); or in the area around the spine (not shown).

In stage III childhood non-Hodgkin lymphoma, cancer is found:

• in at least one area above the diaphragm and in at least one area below the diaphragm; or
• to have started in the chest; or
• to have started in the abdomen and spread throughout the abdomen and cannot be completely removed by surgery; or
• in the area around the spine.

Estadio 4

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Stage IV childhood non-Hodgkin lymphoma. Cancer is found in the bone marrow, brain, or cerebrospinal fluid (CSF). Cancer may also be found in other parts of the body.

In stage IV childhood non-Hodgkin lymphoma, cancer is found in the bone marrow, brain, or cerebrospinal fluid. Cancer may also be found in other parts of the body.

Sometimes childhood non-Hodgkin lymphoma does not respond to treatment or recurs (comes back) after treatment.

Refractory non-Hodgkin lymphoma is cancer that does not respond to initial treatment.

Recurrent non-Hodgkin lymphoma is cancer that has come back after treatment. It may come back in the lymph system or in other parts of the body.

There are different types of treatment for children with non-Hodgkin lymphoma.

Different types of treatment are available for children with non-Hodgkin lymphoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Taking part in a clinical trial should be considered for all children with non-Hodgkin lymphoma. Some clinical trials are open only to patients who have not started treatment.

Children with non-Hodgkin lymphoma should have their treatment planned by a team of doctors who are experts in treating childhood cancer.

Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children with non-Hodgkin lymphoma and who specialize in certain areas of medicine. These may include the following specialists:

• Pediatra.
• Oncólogo radioterapeuta.
• hematólogo pediátrico.
• cirujano pediátrico.
• Enfermera pediátrica especialista.
• Especialista en rehabilitación.
• Psicólogo.
• Trabajador social.

Eight types of treatment are used:

Quimioterapia

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid (intrathecal chemotherapy), an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. Combination chemotherapy is treatment using two or more anticancer drugs.

Intrathecal chemotherapy may be used to treat childhood non-Hodgkin lymphoma that has spread, or may spread, to the brain. When used to lessen the chance cancer will spread to the brain, it is called CNS prophylaxis. Intrathecal chemotherapy is given in addition to chemotherapy by mouth or vein. Higher than usual doses of chemotherapy may also be used as CNS prophylaxis.

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Intrathecal chemotherapy. Anticancer drugs are injected into the intrathecal space, which is the space that holds the cerebrospinal fluid (CSF, shown in blue). There are two different ways to do this. One way, shown in the top part of the figure, is to inject the drugs into an Ommaya reservoir (a dome-shaped container that is placed under the scalp during surgery; it holds the drugs as they flow through a small tube into the brain). The other way, shown in the bottom part of the figure, is to inject the drugs directly into the CSF in the lower part of the spinal column, after a small area on the lower back is numbed.

The way the chemotherapy is given depends on the type and stage of the cancer being treated.

For more information, see Drugs Approved for Non-Hodgkin Lymphoma.

High-dose chemotherapy with stem cell transplant

High doses of chemotherapy are given to kill cancer cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. Stem cell transplant is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

For more information, see Drugs Approved for Non-Hodgkin Lymphoma.

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Trasplante de células madre de donante. (Paso 1): De cuatro a cinco días antes de la recolección de células madre del donante, este recibe un medicamento para aumentar la cantidad de células madre que circulan por el torrente sanguíneo (este paso no se ilustra). Luego, las células madre responsables de la producción de sangre se extraen del donante a través de una vena principal en su brazo. La sangre fluye a través de una máquina de aféresis que elimina las células madre. El resto de la sangre regresa al donante por una vena en el otro brazo. (Paso 2): El paciente recibe quimioterapia para eliminar las células cancerosas y preparar el cuerpo para las células madre del donante. También puede recibir radioterapia (no se ilustra). (Paso 3): El paciente recibe una infusión de las células madre del donante.

Se están probando nuevos tipos de tratamiento en ensayos clínicos.

Esta sección resume los tratamientos que se están estudiando en ensayos clínicos. Es posible que no se mencionen todos los tratamientos nuevos que se están estudiando. La información sobre los ensayos clínicos está disponible en el sitio web del NCI.

Los pacientes pueden valorar la posibilidad de participar en un ensayo clínico.

Para algunos pacientes, participar en un ensayo clínico puede ser la mejor opción de tratamiento. Los ensayos clínicos son parte del proceso de investigación del cáncer y se realizan para determinar si los nuevos tratamientos para el cáncer son seguros y eficaces o mejores que el tratamiento estándar.

Muchos de los tratamientos estándar actuales para el cáncer se basan en ensayos clínicos anteriores. Los pacientes que participan en un ensayo clínico pueden recibir el tratamiento estándar o ser de los primeros en recibir uno nuevo.

Los pacientes que participan en ensayos clínicos también ayudan a mejorar la forma en que se tratará el cáncer en el futuro. Incluso cuando los ensayos clínicos no conducen a nuevos tratamientos efectivos, suelen responder a preguntas clave y contribuir de forma significativa al avance de la investigación.

Los pacientes pueden participar en ensayos clínicos antes, durante o después de comenzar su tratamiento del cáncer.

Algunos ensayos clínicos sólo incluyen a pacientes que aún no han recibido tratamiento. Otros ensayos prueban tratamientos para pacientes cuyo cáncer no ha mejorado. También hay ensayos clínicos que prueban nuevas formas de evitar que el cáncer reaparezca o de reducir los efectos secundarios del tratamiento del cáncer.

Se están realizando ensayos clínicos en muchas partes del país. Puede encontrar información sobre los ensayos clínicos respaldados por el NCI en la página web de búsqueda de ensayos clínicos del NCI. Puede encontrar ensayos clínicos respaldados por otras organizaciones en el sitio web ClinicalTrials.gov.

Pueden ser necesarias pruebas de seguimiento.

A medida que su hijo se somete al tratamiento, se le harán pruebas o controles de seguimiento. Es posible que se repitan algunas pruebas que se realizaron para diagnosticar o estadificar el cáncer para ver en qué medida está funcionando bien el tratamiento. Las decisiones sobre si continuar, cambiar o suspender el tratamiento pueden basarse en los resultados de estas pruebas.

Algunas de las pruebas se seguirán realizando periódicamente después de que finalice el tratamiento. Los resultados de estas pruebas pueden mostrar si la afección de su hijo ha cambiado o si el cáncer ha reaparecido (recaído).

Burkitt lymphoma/leukemia

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, su edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Linfoma difuso de células B grandes

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, su edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Primary Mediastinal B-cell Lymphoma

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, su edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Lymphoblastic Lymphoma

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, su edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Anaplastic Large Cell Lymphoma

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, su edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Lymphoproliferative Disease Associated With Immunodeficiency in Children

Rare NHL Occurring in Children

Acerca del PDQ

El Physician Data Query (PDQ) es la base de datos integral sobre el cáncer del National Cancer Institute (NCI). La base de datos del PDQ contiene resúmenes con la última información publicada sobre prevención, detección, genética, tratamiento, atención médica de apoyo y medicina complementaria y alternativa relacionada con el cáncer. La mayoría de los resúmenes se redactan en dos versiones. Las versiones para profesionales de la salud contienen información detallada escrita en lenguaje técnico. Las versiones para pacientes están redactadas en un lenguaje fácil de entender y no tan técnico. Ambas versiones contienen información correcta y actualizada sobre el cáncer. La mayoría de las versiones también están disponibles en español.

El PDQ es un servicio del NCI. El NCI es parte de los Institutos Nacionales de Salud (NIH), que son el centro de investigación biomédica del gobierno federal. Los resúmenes del PDQ se basan en una revisión independiente de la literatura médica. No son declaraciones de políticas del NCI ni de los NIH.

Propósito de este resumen

This PDQ cancer information summary has current information about the treatment of childhood non-Hodgkin lymphoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Revisores y actualizaciones

Los consejos editoriales escriben los resúmenes de información sobre el cáncer del PDQ y los mantienen actualizados. Estos consejos están formados por equipos de especialistas en el tratamiento del cáncer y otras especialidades relacionadas con esta enfermedad. Los resúmenes se revisan periódicamente y se modifican cuando hay información nueva. La fecha de actualización al pie de cada resumen indica cuándo se realizó el cambio más reciente.

La información de este resumen para pacientes procede de la versión para profesionales de la salud, la cual el Consejo editorial del PDQ sobre el tratamiento pediátrico revisa y actualiza de forma periódica según sea necesario.

Información sobre ensayos clínicos

Un ensayo clínico es un estudio para responder a una pregunta científica como, por ejemplo, si un tratamiento es mejor que otro. Los ensayos se basan en estudios anteriores y en lo aprendido en el laboratorio. Cada ensayo responde a determinadas preguntas científicas que permiten encontrar nuevas y mejores formas de ayudar a los pacientes con cáncer. Durante los ensayos clínicos de tratamiento, se recopila información sobre los efectos de un nuevo tratamiento y su eficacia. Si un ensayo clínico demuestra que un nuevo tratamiento es mejor que uno que se utiliza actualmente, el nuevo tratamiento puede convertirse en “estándar”. Los pacientes pueden valorar la posibilidad de participar en un ensayo clínico. Algunos ensayos clínicos solo están abiertos a pacientes que no hayan iniciado el tratamiento.

Los ensayos clínicos se pueden encontrar en línea en el sitio web del NCI. Para obtener más información, llame al Servicio de Información sobre el Cáncer (CIS, por sus siglas en inglés), el centro de contacto del NCI, al 1-800-4-CANCER (1-800-422-6237).

Permiso de uso de este resumen

Physician Data Query (PDQ, por sus siglas en inglés) es una marca registrada. Se autoriza el libre uso del contenido de los documentos del PDQ como texto. Sin embargo, no se podrá identificar como un resumen de información sobre cáncer del PDQ del NCI, salvo que se reproduzca en su totalidad y se actualice con regularidad. Por otra parte, se permite que los autores incluyan una oración como “en el resumen del PDQ del NCI sobre la prevención del cáncer de mama se describen, de manera concisa, los siguientes riesgos: [incluir fragmento del resumen]”.

La forma recomendada para citar este resumen del PDQ es:

PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Non-Hodgkin Lymphoma Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/lymphoma/patient/child-nhl-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389294]

Las imágenes de este resumen se utilizan con el permiso del autor, artista y/o editorial para uso exclusivo en los resúmenes del PDQ. Si desea usar una imagen de un resumen del PDQ sin incluir el resumen completo, debe obtener autorización del propietario. El National Cancer Institute no puede otorgar dicho permiso. Para obtener más información sobre el uso de las imágenes de este resumen o de otras ilustraciones relacionadas con el cáncer, consulte Visuals Online, una colección de más de 3,000 imágenes científicas.

Descargo de responsabilidad

La información de estos resúmenes no debe utilizarse para tomar decisiones sobre reembolsos de seguros. Puede encontrar más información sobre la cobertura de seguros en Cancer.gov en la página Manejo de la atención del cáncer.

Contáctenos

Puede encontrar más información sobre cómo contactarnos o recibir ayuda en el sitio web Cancer.gov en la página Comuníquese con el NCI. También puede enviar sus preguntas a Cancer.gov en el apartado Escríbanos del sitio web.