Childhood Leukaemia: Types, Symptoms, Risk Factors, Diagnosis, Treatments

Medically Reviewed by Dr. K. on May 18, 2022.

Childhood Leukemia

Childhood leukaemia is a cancer of the white blood cells and is the most prevalent form of cancer in children and teenagers. In the bone marrow, abnormal white blood cells develop. They move rapidly across the bloodstream, crowding out good cells in the process. Which increases the risk of infection and other complications in the body.

It's comforting to note that, as difficult as it is for a child to have cancer, most children and teenagers with childhood leukaemia will be successfully treated.

Risk Factors Contributing To Childhood Leukemia

Most forms of childhood leukaemia are caused by unknown factors, according to doctors. However, some factors can increase your chances of having it. However, possessing one of these causes would not guarantee that a child may have leukaemia. In reality, the vast majority of children with leukaemia have no established risk factors.

If your child has either of the following conditions, he or she is more likely to have childhood leukaemia:

  • An inherited disorder such as Li-Fraumeni syndrome, Down syndrome, or Klinefelter syndrome
  • An inherited immune system problem such as ataxia telangiectasia
  • A brother or sister affected by leukemia, especially an identical twin.
  • Having been subjected to heavy doses of radiation, chemotherapy, or toxins like benzene (a solvent) in the past.
  • A history of immune system suppression, such as for an organ transplant

Despite the low chance, doctors recommend that children with conditions that increase the risk of leukaemia get routine screening to detect any complications early.

Types of Childhood Leukemia

Childhood leukaemia is almost often acute, which suggests it develops quickly. Just a small percentage of cases are chronic and develop slowly.

There are several forms of leukaemia that affect children, including:

  • Acute lymphoblastic leukemia (ALL), also called acute lymphocytic leukemia: ALL is the most common, accounting for 3 out of every 4 cases of childhood leukemia.
  • Acute myelogenous leukemia (AML): AML is the next most common type of childhood leukemia.
  • Hybrid or mixed lineage leukemia: This is a rare leukemia with features of both ALL and AML.
  • Chronic myelogenous leukemia (CML): CML is rare in children.
  • Chronic lymphocytic leukemia (CLL): CLL is very rare in children.
  • Juvenile myelomonocytic leukemia (JMML): This is a rare type that is neither chronic or acute and happens most often in children under age 4.

Symptoms of Childhood Leukemia

Leukemia symptoms often warrant a doctor's appointment. This is a positive thing because it ensures the disease would likely be detected sooner than it would otherwise. Early detection may contribute to more effective treatment.

When leukaemia cells crowd out regular cells, certain signs and symptoms of childhood leukaemia appear.

Symptoms that are common include:

  • Fatigue
  • Pale complexion
  • Fever
  • Frequent infections
  • Easy bruising
  • Easy bleeding
  • Excessive fatigue or weakness
  • Shortness of breath
  • Coughing

Other symptoms may include:

  • Pain in the bones or joints.
  • Swelling of the abdomen, face, arm, underarm, sides of neck, or groin.
  • Swelling that extends above the collarbone.
  • Loss of appetite
  • Unintentional weight loss
  • Headaches
  • Seizures
  • Balance issues
  • Abnormal vision
  • Vomiting
  • Rashes.
  • Gum diseases

Diagnosing Childhood Leukemia

The doctor will take a detailed medical history and conduct a comprehensive physical examination to detect childhood leukaemia. Tests are used to detect and identify the types of childhood leukaemia.

The following are few examples of preliminary tests:

  • Blood tests: Blood samples are used to determine the number of blood cells and their appearance.
  • Bone marrow biopsy: To affirm a diagnosis of leukaemia, a bone marrow aspiration and biopsy is performed, normally from the pelvic bone.
  • Lumbar puncture: A lumbar puncture, also known as a spinal tap, is a procedure used to search for the spread of leukaemia cells in the fluid around the brain and spinal cord.

Under a microscope, a pathologist examines cells from blood samples. This specialist often records the amount of blood-forming cells and fat cells in bone marrow samples.

Other scans may be performed to assess the type of leukaemia that your child has. These checks also inform doctors of the likelihood of the leukaemia responding to therapy.

Depending on how the child reacts to treatment, such tests may be repeated later.

Treatments for Childhood Leukemia

Discuss the right choices for your child with your child's doctor and other members of the cancer treatment team. Treatment is mostly determined by the type of leukaemia as well as other factors.

Many forms of childhood leukaemia have improved their survival rates over time. Treatment for children and teenagers in special facilities provides the added benefit of intensive care. Childhood cancers react to treatment more favourably than adult cancers, and children's bodies are more tolerant of treatment.

Prior to starting cancer therapy, a child may require treatment to resolve disease complications. Changes in blood cells, for example, may result in infections or serious bleeding, as well as a reduction in the amount of oxygen supplying the body's tissues. Antibiotics, blood transfusions, and other infection-fighting methods can be used.

The most common cure for childhood leukaemia is chemotherapy. Anticancer medications will be administered to the child via the mouth, a vein, or the spinal fluid. Maintenance treatment in phases over 2 to 3 years may be used to prevent leukaemia from returning.

Targeted treatment is also used on occasion. This treatment differs from conventional chemotherapy in that it treats specific parts of cancer cells. Targeted treatment is effective with some cases of childhood leukaemia which has less adverse effects.

Radiation therapy is one method of treatment that can be used. Cancer cells are killed and cancers are shrunk using high-energy radiation. It may also aid in the prevention or treatment of leukaemia spreading to other areas of the body. Surgery is a last resort for children with leukaemia.

A stem cell transplant could be the best choice if conventional therapy is unlikely to be successful. It entails the transplantation of blood-forming stem cells after the child's bone marrow has been destroyed by whole-body radiation and high-dose chemotherapy.

The FDA has authorised a form of gene therapy for children and young adults up to 25 years old with B-cell ALL who have failed to respond to other treatments. Scientists are developing a variant of this treatment for individuals above the age of 25 and for other types of cancer.

CAR T-cell therapy treats tumours by using some of your own immune cells, known as T cells. Doctors take the blood cells and alter them by inserting new genes. The new T cells are more capable of detecting and killing cancer cells.

Source:

Referenced on 28/4/2021

  1. American Cancer Society: “Childhood Leukemia."
  2. Nemours Foundation: “Childhood Cancer: Leukemia."
  3. FDA: “FDA approval brings first gene therapy to the United States."
  4. https://www.webmd.com/cancer/lymphoma/childhood-leukemia-symptoms-treatments

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