n HOW LONG WILL MY CHILD’S THERAPY LAST? The length of your child’s therapy will depend on the stage of the disease and its risk group. Usually, treatment is given for 2–6 months, but it can take longer depending on the specific treatment plan. The duration of treatment may be modified based on your child’s response to treatment after 4–8 weeks.
n WHAT IF THE CANCER RECURS? It is possible for Hodgkin lymphoma to recur, which is called a recurrence or relapse. If your child has a relapse, his or her treatment may involve additional chemotherapy, radiation therapy, newer agents like immunotherapy or targeted therapy, or stem cell transplant. Immunotherapy The immune system is the body’s natural defense against infection and disease. Immunomodulators are drugs that modify different parts of that system to boost its function, stop cancer cells from increasing in number, and stop the growth of new blood vessels that provide nutrients to the cancer. This new form of treatment may be used to treat classical Hodgkin lymphoma that was not cured by first-time treatment, and your treatment team may consider using it if additional chemotherapy fails. Because this type of treatment still is new, it usually is administered as part of a clinical trial. We will discuss what this means in the next section on page 8. Targeted Therapy Like immunotherapy, targeted therapy also is a new form of treatment. This class of drugs stops the action of molecules that help cancer cells grow by targeting these molecules on the surface of cancer cells. Targeted therapy is not yet widely used to treat Hodgkin lymphoma, but it may be a treatment option if the cancer recurs. The most common targeted therapy used in Hodgkin lymphoma is a drug called brentuximab. This drug binds to a specific protein on the Hodgkin-Reed Sternberg cell to help destroy it. Stem Cell Transplant Blood stem cells are cells that eventually develop into mature blood cells. The body makes stem cells in the bone marrow, which is the richest source of these cells. Stem cells also are present in the blood stream, although in small quantities, and their amount can be increased with certain drugs. In the treatment of cancer, stem cells are used to restore blood and immune cell formation after intense chemotherapy, radiation therapy, or both have been administered. The goal of stem cell transplant in the treatment of Hodgkin lymphoma is to replace the healthy bone marrow stem cells that are destroyed during a very intense form of chemotherapy called high-dose chemotherapy. Unlike the chemotherapy used for first-time treatment of cancer, this high-dose chemotherapy kills off cancer cells and wipes out the stem cells in the bone marrow, meaning they no longer are able to produce blood cells. During a stem cell transplant, stem cells are collected from a patient with Hodgkin lymphoma before high-dose chemotherapy is administered. After the high-dose chemotherapy, the patient’s collected stem cells are replaced through infusion so that they are able to function again.
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