Leukemia, or blood cancer, is a malignancy of the white blood cells, the cells that fight infection in the bloodstream. Children with leukemia produce a large number of abnormal white blood cells inside the bone marrow, the space inside bones that produces all blood cells. These abnormal cells crowd out the other types of blood cells inside the bone marrow, leading to anemia, or decreased red blood cells, and thrombocytopenia, or decreased platelets.
Significance
According to the Nemours Foundation, leukemia accounts for 1/4 of all cancers diagnosed in children in the United States. About 2,200 children are diagnosed with leukemia every year. Medical advances have made leukemia a treatable disease, with most children surviving more than five years after the diagnosis.
Types
The Leukemia and Lymphoma Society identifies four major types of leukemias: acute lymphocytic leukemia, chronic lymphocytic leukemia, acute myelogenous leukemia and chronic myelogenous leukemia. The terms lymphocytic and myelogenous depend on the abnormal cell types involved. The acute leukemias advance quickly, while the chronic leukemias take longer to show symptoms. Most children have acute leukemia, with acute lymphocytic leukemia the most common type.
Symptoms
The symptoms of leukemia are nonspecific but are related to the decrease in the number of blood cells. A decrease in the number of platelets, the cells in charge of clotting off blood, leads to easy bruising and bleeding. A decrease in the red blood cells leads to anemia and fatigue. Since the white blood cells in leukemia are abnormal, they cannot fight off infections efficiently, leading to opportunistic infections and recurrent fevers. Occasionally children with leukemia will present with bone pain or a limp, which can be mistaken for a benign condition.
Diagnosis
A complete blood cell count usually detects abnormalities in the numbers of the blood cells. A definitive diagnosis needs a bone marrow aspiration, a procedure during which a needle is bored into a bone, usually in the pelvis or the leg, and the contents of the bone marrow aspirated. This is sent to a laboratory for genetic testing that determines the type of leukemia.
Treatment
The treatment of leukemia depends on the specific type of the disease. In general, children undergo induction therapy with chemotherapy to bring the disease under control. Once the cancer is in remission, children go through a phase called consolidation, to prevent the cancer from coming back. Close followup and long-term monitoring are important to prevent recurrence of the disease.
