Children shouldn’t experience cancer. The disease should be left to those who’ve spent a few more years on this earth.
While cancer is rare in children, it does strike thousands every year in this country. And cancers that develop in the blood, or leukemias, are the most common.
The good news is that most kids beat leukemia, and the battle to improve the odds even more is making impressive advances.
What is leukemia?
Leukemia starts in the blood cells and makes them grow out of control, interfering with the function of other cells in the body. These blood cells are formed in the bone marrow.
Most childhood leukemias start in the white blood cells, which are part of the immune system and fight off infections and other invaders.
There are several types of white blood cells, and most childhood leukemias start in the lymphocytes.
Types of childhood leukemias
Leukemias can be either fast-growing (acute) or slow-growing (chronic). Most children have acute leukemias:
- Acute lymphocytic (lymphoblastic) leukemia (ALL) is the most common type of leukemia found in children.
- Acute myelogenous leukemia (AML) – also called acute myeloid leukemia, acute myelocytic leukemia or acute non-lymphocytic leukemia – accounts for most of the remaining cases. AML starts from the myeloid cells that form other blood cells.
Chronic leukemias, including chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) are seen much more often in adults than in kids.
Juvenile myelomonocytic leukemia (JMML) is quite rare and appears in children under the age of four.
dailyRx News had the privilege of talking to world renowned leukemia researcher, Ching-Hon Pui, MD, chair of Department of Oncology at St. Jude Children's Research Hospital.
He told us, “Acute lymphoblastic leukemia makes up about 75 percent of cases; 20 percent are acute myeloid leukemia and the others include chronic myeloid leukemia, juvenile myelomonocytic leukemia, myelodysplasia. Overall, acute lymphoblastic leukemia is the most common childhood cancer.”
Symptoms of childhood leukemia
Leukemia often starts out behaving like the flu or other common conditions. If the following symptoms appear and don’t seem to get better, a doctor’s visit is warranted:
- Infections that appear frequently
- Fevers that don’t go away
- Weakness, fatigue, sleepiness, irritability
- Pain in the bones or joints
- Enlarged lymph nodes under the arms, in the neck or in the groin
- Pale look
- Bleeding or bruising easily or often
- Doctor-detected enlarged liver or spleen
“Acute lymphoblastic leukemia (ALL) most often affects children 2 to 5 years old, but can occur at any age,” Dr. Pui said. “Each year, there are 6,000 new cases of ALL, 3,600 occurring in children.”
What causes childhood leukemia?
While the exact answer to this question is unknown, physicians do know that leukemia more often occurs in children with the following characteristics:
- Having a twin or sibling who developed the disease before the age of 6
- Having inherited certain genetic conditions such as Li-Fraumeni syndrome, Down syndrome, Kleinfelter syndrome, neurofibromatosis, ataxia telangectasia or Fanconi's anemia
- Are taking medications to suppress the immune system
- Having received either radiation or chemotherapy to treat another form of cancer
Leukemia develops more often in boys than in girls and is more common in Caucasians than in African Americans.
How is childhood leukemia diagnosed and treated?
Diagnosis begins with a blood test. This may be followed by a bone marrow biopsy in which a sample of bone marrow tissue is gathered and examined under a microscope.
A biopsy may also be performed on the lymph nodes. Spinal fluid may be gathered and tested.
Once diagnosed, childhood leukemia is treated with chemotherapy which works to kill cancer cells wherever they may be in the body.
Radiation (intense energy rays) may also be used to kill cancer cells, although this treatment is less common today than it used to be.
Stem cell transplants – also known as bone marrow transplants – are used to treat the most serious cases of childhood leukemia.
Special stem cells that form into healthy blood cells are used. The child’s own cells can be used, as can the stem cells from another person.
Most kids live beyond a leukemia diagnosis
“Ninety percent of children with ALL and up to 70 percent with acute myeloid leukemia can be cured to date,” Dr. Pui told us.
“Precise risk-directed chemotherapy and excellent supportive care account mainly for the improved outcome. We now can cure them without the use of any radiation which was part of the standard treatment in the past,” Dr. Pui said.
What advances are being made in the fight against childhood leukemia?
Dr. Pui explained that therapies are continuing to improve the outlook for children with childhood leukemia. “Recent advances in pharmacogenetics and molecular genetics promise to further improve outcome. We can now identify some patients that can benefit from molecular target therapy (such as Gleevec, Sprycel). We have also made a lot of advances in immunotherapy and cellular therapy which should also further improve outcome,” Dr. Pui said.
What’s heartening about this story is that the fight against the most common form of childhood cancer is being won.
But the war won’t be over until every child beats this disease and grows up to live a normal life.