Childhood leukemia

Childhood leukemia, the most common type of cancer in children and teens, is a cancer of the white blood cells. Abnormal white blood cells form in the bone marrow. They quickly move through the bloodstream and crowd out healthy cells. This increases the chances of infection of the body and other problems.

As difficult as it is for a child to get cancer, it is good to know that most children and teens with childhood leukemia can be successfully treated.

Factors that increase the likelihood of childhood leukemia

Doctors don't know exactly what causes most cases of childhood leukemia. But some things can increase the chances of getting it. Keep in mind, however, that having any of these things does not necessarily mean that a child will have leukemia. In fact, most children with leukemia have no known risk factors.

The risk of childhood leukemia is increased if your child has:

An inherited disorder such as Li-Fraumeni syndrome, Down syndrome or Klinefelter syndrome.
Hereditary problems with the immune system, such as ataxia-telangiectasia.
A sibling with leukemia, especially an identical twin
History of exposure to high levels of radiation, chemotherapy, or chemicals such as benzene
History of suppression of the immune system, such as for organ transplants

While the risk is low, doctors say children who have signs that make leukemia more likely should have regular checkups to catch any problems early.

Types of childhood leukemia

Almost all cases of childhood leukemia are acute, meaning they grow rapidly. A small number are chronic and develop slowly.

Types of childhood leukemia include:

Acute lymphoblastic leukemia, also called acute lymphoid leukemia. Acute lymphoblastic leukemia accounts for 3 out of 4 cases of childhood leukemia.
Acute myelogenous leukemia The second most common type of childhood leukemia.
Hybrid or mixed leukemia. It is a rare leukemia with features of acute lymphoblastic leukemia and acute myeloid leukemia.
Chronic myelogenous leukemia is rare in children.
Chronic lymphocytic leukemia in children is very rare.
Juvenile myelomonocytic leukemia. This is a rare type that is neither chronic nor acute and most commonly occurs in children under 4 years of age.

Symptoms of childhood leukemia

Symptoms of leukemia often require a visit to the doctor. This is good because it means the disease can be detected sooner than otherwise. Early diagnosis can lead to more effective treatment.

Many of the signs and symptoms of childhood leukemia occur when leukemia cells crowd out normal cells.

Common symptoms include:

Fatigue or pale skin
Infections and fever
Easy bleeding or bruising
Extreme fatigue or weakness
Shortness of breath
Cough

Other symptoms may include:

Pain in the bones or joints
Swelling of the abdomen, face, arms, armpits, sides of the neck, or groin
Swelling over the collarbone
Loss of appetite or weight loss
Headaches, seizures, balance problems or abnormal vision
Vomiting
Rash
Problems with gums

Diagnosis of childhood leukemia

To diagnose childhood leukemia, a doctor will take a complete medical history and perform a physical examination. The tests are used to diagnose childhood leukemia and also to classify its type.

Initial tests may include:

Blood tests to measure the number of blood cells and see how they appear
Bone marrow aspiration and biopsy, usually taken from the pelvic bone, to confirm the diagnosis of leukemia
Lumbar puncture or lumbar puncture to check for spread of leukemic cells in the fluid surrounding the brain and spinal cord.

The pathologist examines the cells of a blood test under a microscope. This specialist also checks bone marrow samples for the number of hematopoietic cells and fat cells.

Other tests may be done to help determine the type of leukemia your child may have. These tests also help doctors determine the likelihood that leukemia is treatable.

Some tests may be repeated later to see how your child is responding to treatment.

Treatment of childhood leukemia

Talk honestly with your child's doctor and other members of the cancer care team about the best options for your child. Treatment depends mainly on the type of leukemia, as well as other factors.

Survival rates for most types of childhood leukemia have increased over time. And treatment in special centers for children and teens has the advantages of specialized care. Cancer in children generally responds better to treatment than cancer in adults, and children's bodies often tolerate treatment better.

Before starting cancer treatment, a child sometimes needs treatment to treat complications of the disease. For example, changes in blood cells can lead to severe infection or bleeding and affect the amount of oxygen reaching body tissues. Treatment may include antibiotics, blood transfusions, or other measures to fight infection.

Chemotherapy is the main treatment for childhood leukemia. Your child will receive cancer medicine by mouth, through a vein, or through the spinal fluid. To prevent recurrence of leukemia, maintenance treatment can be given in cycles of 2 or 3 years.

Sometimes targeted therapy is also used. This therapy targets specific parts of the cancer cells, functioning differently from standard chemotherapy. While effective in some types of childhood leukemia, targeted therapies often have less severe side effects.

Other treatments may include radiation therapy. It uses high-energy radiation to kill cancer cells and shrink tumors. It may also help prevent or treat the spread of leukemia to other parts of the body. Surgery is rarely a treatment option for childhood leukemia.

If standard treatment is likely to be less effective, a stem cell transplant may be a better option. This is a hematopoietic stem cell transplant after whole-body radiation therapy combined with high-dose chemotherapy first destroys the baby's bone marrow.

CAR T cell therapy uses some of your own immune cells, called T cells, to treat cancer. Doctors take cells from your blood and modify them with new genes. The new T cells are better able to find and destroy cancer cells.