The term leukemia refers to cancers of the white blood cells. When someone has leukemia, large numbers of abnormal white blood cells are produced in the bone marrow. These abnormal white cells crowd the bone marrow and flood the bloodstream, but they cannot perform their proper role of protecting the body against disease because they are defective.
As leukemia progresses, the cancer interferes with the body's production of other types of blood cells, including red blood cells and platelets. This results in anemia and bleeding problems, in addition to the increased risk of infection caused by white cell abnormalities.
In general, leukemia’s are classified into acute and chronic forms. In children, most leukemia’s are acute.
In most cases, neither parents nor kids have control over the factors that trigger leukemia. Most leukemia’s arise from non-inherited mutations in the genes of growing blood cells. Because these errors occur randomly and unpredictably, there is currently no effective way to prevent most types of leukemia.
Because their infection-fighting white blood cells are defective, kids with leukemia may have more viral or bacterial infections than usual. They also may become anemic because leukemia affects the bone marrow's production of oxygen-carrying red blood cells. This makes them appear pale, and they may become abnormally tired and short of breath while playing.
Children with leukemia might bruise and bleed very easily, experience frequent nosebleeds, or bleed for an unusually long time after even a minor cut because leukemia destroys the bone marrow's ability to produce clot-forming platelets.
Other symptoms of leukemia can include:
- pain in the bones or joints
- swollen lymph nodes
- an abnormally tired feeling
- poor appetite
- fevers with no other symptoms
- abdominal pain
Occasionally, the spread of leukemia to the brain can cause headaches, seizures, balance problems, or abnormal vision. If Leukemia spreads to the lymph nodes inside the chest, the enlarged mass can crowd the windpipe and important blood vessels, leading to breathing problems, and interfere with blood flow to and from the heart.
To determine whether a child has leukemia, a doctor will do a physical examination to check for signs of infection, anemia, abnormal bleeding, and swollen lymph nodes. The doctor will also feel the child's abdomen to check the liver and spleen because these organs can become enlarged by some childhood cancers. The doctor will order a complete blood count to measure the numbers of white cells, red cells, and platelets in the child's blood.
Then, depending on the results of the physical exam and preliminary blood tests, the child might need:
- a bone marrow biopsy and aspiration, in which marrow samples are removed for testing
- a lymph node biopsy, in which lymph nodes are removed and examined under a microscope to look for abnormal cells
- a lumbar puncture, where a sample of spinal fluid is removed from the lower back and examined for evidence of abnormal cells. This will show whether the leukemia has spread to the central nervous system.
- imaging studies, such as X-rays, ultrasounds, CT scans, or MRIs
Chemotherapy is the main treatment for childhood leukemia, although the dosages and drug combinations may differ. Chemo can be given by mouth, into a vein, or into the spinal fluid.
Intensive leukemia chemotherapy has certain side effects, including hair loss, nausea and vomiting, and increased risk for infection or bleeding in the short term, as well as other potential health problems later.
Other types of treatment include radiation therapy that kill cancer cells, targeted therapy and stem cell transplants.
With the proper treatment, the outlook for kids and teens that are diagnosed with leukemia is quite good. Most childhood leukemia’s have very high remission rates. Overall cure rates differ depending on the specific features of the disease. And the majority of kids can be cured of the disease and live happy, successful and prosperous lives.