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- Ilia N. Buhtoiarov, MD*
- *Pediatric Leukemia and Lymphoma Clinic, Cleveland Clinic Children’s Hospital, Cleveland, OH
AUTHOR DISCLOSURE
Dr Buhtoiarov has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- CAR:
- chimeric antigen receptor
- cHL:
- classic Hodgkin lymphoma
- CNS:
- central nervous system
- CT:
- computed tomography
- EBV:
- Epstein-Barr virus
- HIV:
- human immunodeficiency virus
- HL:
- Hodgkin lymphoma
- HRSC:
- Hodgkin Reed-Sternberg cell
- HSCT:
- hematopoietic stem cell transplantation
- Ig:
- immunoglobulin
- LN:
- lymph node
- NHL:
- non-Hodgkin lymphoma
- NLPD:
- nodular lymphocyte–predominant
- SVC:
- superior vena cava
- TLS:
- tumor lysis syndrome
- UA:
- uric acid
Education Gaps
Painless lymphadenopathy is one of the commonest presentations of pediatric lymphoma. Absence of the absolute lymphoma-specific signs and symptoms makes it a particular diagnostic challenge. Lack of systemic symptoms does not preclude a malignant transformation. High level of suspicion is critical for timely patient referral to a pediatric oncologist. Outstanding survival rates may be compromised by a substantial prevalence of the therapy-related side effects.
Objectives
After completing the article, readers should be able to:
Recognize genetic and environmental factors contributing to development of lymphoma.
Identify clinical parameters that can be used to predict the nonbenign nature of lymphadenopathy.
Recognize lymphoma-associated oncologic emergencies.
Diagnose tumor lysis syndrome and propose prophylactic and therapeutic interventions.
Discuss therapeutic options and recognize therapy-related side effects.
Introduction
Lymphoma is the third most frequent childhood malignancy (prevalence rate of 12%–15%), closely following acute leukemia and central nervous system (CNS) tumors. Most pediatric patients with lymphoma will survive their disease into adulthood. Having a high threshold of clinical suspicion at the time of first assessment, along with performing problem-oriented initial tests, followed by prompt referral to the pediatric lymphoma expert for further evaluation and specialized treatment, are the pillars of therapeutic success. This review will serve to update the readership on pediatric lymphoma epidemiology and known predisposition factors, clinical presentation, diagnostic tests, and therapeutic options, as well as treatment-related side effects that may need to be recognized while taking care of lymphoma survivors.
Lymphoma is a neoplasm caused by malignant transformation of lymphoid cells. Advances in the understanding of lymphoma biology led to development of risk- and response-adapted therapies, which caused lymphomas to be one of the most curable pediatric cancers. The …
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In this issue
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- Article
- Education Gaps
- Objectives
- Introduction
- Biology and Epidemiology of Lymphoma
- Clinical Presentation
- Oncologic Emergencies in Newly Diagnosed Lymphoma
- Approaches to Diagnosis
- Lymphoma Therapy: Risk- and Response-Adapted Therapeutic Approaches
- Disease Surveillance After Therapy Completion
- Late Effects of Therapy
- Conclusions and Further Directions
- References
- Figures & Data
- Supplemental
- Info & Metrics
- Comments
- Quiz
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