lymphoma cancer stages

Stages of non-Hodgkin's lymphoma in children

The staging describes the size of the lymphoma in the body and its location during the initial diagnosis. This is often referred to as the extent of lymphoma. The information revealed by the examinations is used to determine the size of the tumor, whether the lymphoma has spread from its place of origin and where it has spread. Your child's care team uses the stage to plan for treatment and anticipate the outcome (prognosis).

The most frequently used staging system for non-Hodgkin's lymphoma (NHL) in children, or infant, is the St. Jude staging System. In the case of the NHL in the child, there are four stages. For stages 1 to 4, Roman numerals I, II, III and IV are often used. But in order to make the text clearer, we will use Arabic numerals 1, 2, 3 and 4. In general, the higher the number of the stage, the more the lymphoma spread. Talk to your child's doctor if you have any questions about the staging.

St Jude's staging system
The St. Jude staging system can be used for all types of NHL in children, but most often for lymphoblastic lymphoma and anaplastic lymphoma.

Stage One
Lymphoma is found in only one place: either there is 1 tumor out of the lymph nodes or the lymphoma is in 1 group of lymph nodes, such as those of the neck, groin or armpit. Lymphoma is not present in the thorax or abdomen.

Stage 2
Lymphoma is not present in the thorax, but one of the following statements applies.

Lymphoma is in one group of lymph nodes and there is a tumor out of the lymph nodes.
Lymphoma is found in at least 2 groups of lymph nodes that are all located above or below the diaphragm.
There are 2 tumors out of the lymph nodes that are both located above or below the diaphragm.
There is a tumor in the digestive tract (tube that starts from the mouth and goes down to the anus) that can be removed by surgery. Lymphoma may also have spread to nearby lymph nodes.
Stage 3
One of the following statements applies.

There are 2 tumors out of the lymph nodes: one is located above the diaphragm and the other is under the diaphragm.
Lymphoma is found in at least 2 groups of lymph nodes located above and below the diaphragm.
Lymphoma is in the thorax.
The lymphoma is in the abdomen and can not be removed by surgery.
Lymphoma is located in an area near the spine.
Stage 4
Lymphoma is found in the brain or spinal cord, either the central nervous system (CNS), the bone marrow or both.

Risk categories for the B-cell NHL
An infant NHL that originates in B lymphocytes is also classified as a risk category. These risk categories are based on the FAB/LMB system. They assist physicians in planning the treatment of children with B-cell NHL, such as Burkitt lymphoma, Burkitt-type lymphoma, large B-cell diffuse lymphoma, and B-cell primitive mediastinal lymphoma.

Risk category A
Lymphoma is stage 1 or 2 and can be removed by surgery.

Risk category B
Lymphoma is found in multiple areas outside the abdomen or it is stage 1, 2, 3 or 4 and can not be removed by surgery. If the lymphoma is stage 4, it has spread to the bone marrow and less than 25% of the cells are blasts (lymphoma cells). Lymphoma did not spread to the brain or spinal cord.

Risk category C
Lymphoma is stage 4 and is found in the bone marrow, brain or spinal cord. If lymphoma has reached the bone marrow, more than 25% of the cells are blasts.

NHL recidivism in children
The recurrence of an NHL in children means that lymphoma reappears as a result of the treatment. If he reappears at the place where he first started, we are talking about local recidivism. If it reappears in tissues or lymph nodes located near where it first originated, it is referred to as a regional recurrence. It can also reappear in another part of the body: we are talking about relapse or remote metastasis.

Strong NHL
The resistant, or refractory, NHL is a lymphoma that continues to develop or propagate during treatment.