Leukemia is cancer of the blood. It’s the most common form of cancer in childhood. The cancer cells grow in bone marrow and go into the blood. The bone marrow is the soft, spongy center of some bones. It makes blood cells. When a child has leukemia, the bone marrow makes abnormal blood cells that don’t mature. The abnormal cells are usually white blood cells (leukocytes). The bone marrow also makes fewer healthy cells. The abnormal cells reproduce very quickly. They don’t work the same as healthy cells.
The types of blood cells include:
There are different types of leukemia in children. Most leukemias in children are acute, which means they tend to grow quickly. Some of the types of leukemia that occur in children include:
The risk factors for childhood leukemia include:
The symptoms depend on many factors. The cancer may be in the bone marrow, blood, and other tissue and organs. These may include the lymph nodes, liver, spleen, thymus, brain, spinal cord, gums, and skin.
Symptoms can occur a bit differently in each child. They can include:
The symptoms of leukemia can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.
Your child's healthcare provider will ask many questions about your child's symptoms. He or she will examine your child. Your child's healthcare provider may recommend blood tests and other tests. A complete blood count (CBC) provides the number of red blood cells, different types of white blood cells, and platelets. If the results are abnormal, your child's healthcare provider may recommend that your child see a pediatric cancer specialist (pediatric oncologist). The oncologist may want your child to have additional tests including:
When leukemia is diagnosed, the doctor will find out the exact type of leukemia it is. Leukemia is not assigned a stage number like most other cancers. Instead, it's classified into groups, sub-types, or both.
ALL (acute lymphocytic leukemia) is the most common leukemia in children. It's separated into 2 groups based on the type of lymphocyte the leukemia started in. That would be B cells or T cells. About 8 out of 10 cases of ALL in children are B-cell ALLs. These can be further classified into sub-types. The other 2 out of 10 cases are T-cell ALLs.
AML (acute myelogenous leukemia) is the other kind of leukemia that's common in children. Doctors use 2 different systems to classify AML. The French-American-British (FAB) system divides AML into 8 sub-types based on how the cells look under the microscope. The World Health Organization (WHO) classification system is newer. It groups AML into many groups based on things like the details of the gene changes in the cancer cells as well as the FAB sub-types.
Classifying leukemia is very complex. But it's an important part of making treatment plans and predicting treatment outcomes. Be sure to ask your child's healthcare provider to explain the stage of your child's leukemia to you in a way you can understand.
Your child may first need to be treated for low blood counts, bleeding, or infections. Your child may receive:
Treatment will depend on the type of leukemia and other factors. Leukemia can be treated with any of the below:
A child may have complications from the tumor or from treatment. They may also be short-term or long-term.
Treatment may have many side effects. Some side effects may be minor. Some may be serious and even life-threatening. Your child may take medicines to help prevent or lessen side effects. You’ll be given instructions about what you can do at home.
Possible complications of leukemia can include:
Possible long-term complications from the leukemia or the treatment can include:
A child with leukemia needs ongoing care. Your child will be seen by oncologists and other healthcare providers to treat any late effects of treatment and to watch for signs or symptoms of the cancer returning. Your child will be checked with imaging tests and other tests. And your child may see other healthcare providers for problems from the cancer or from treatment.
You can help your child manage his or her treatment in many ways. For example:
Call the healthcare provider if your child has:
Tips to help you get the most from a visit to your child’s healthcare provider: