Leukemia is a kind of cancer that affects the blood, normally impacting the white blood cells in particular. The two most common types of leukemia in children are Acute Lymphoblastic Leukemia and Acute Myelogenous Leukemia.
For someone that is suffering from leukemia, it means that they have underdeveloped blood cells that are being released into their bloodstream, leaving the less healthy blood cells within the body instead.
Here, we will talk about the types of childhood leukemia and their possible symptoms and treatments.
So What is Childhood Leukemia?
According to the American Cancer Society (ACS), ‘Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Overall, however, childhood leukemia is a rare disease.’ In the United States alone, it affects around 3,800 children below the age of 15 every single year.
Leukemia forms when ‘a person’s bone marrow releases new blood cells into the bloodstream before they are even full mature.’ Because they are immature, they cannot function the way that they should. This means that eventually, there will be more immature blood cells than there are healthy ones.
Leukemia can also affect a person’s white and red blood cells and platelets. The bone marrow also produces stem cells, while the blood stem cell can either become a lymphoid stem cell or a myeloid stem cell.
Lymphoid stem cells become white blood cells, while myeloid stem cells can either become white blood cells, red blood cells or platelets.
While leukemia is also known to be typically chronic or acute, the chronic types are normally rare in children. They can though, in fact, include chronic myeloid leukemia or chronic lymphocytic leukemia, which we will further explain below.
Acute Leukemia in Children
Childhood leukemia is said to be acute for the most part, which means that it progresses quickly and requires treatment just as quickly.
1. Acute Lymphoblastic Leukemia (ALL)
The most common type of leukemia in children is acute lymphoblastic leukemia, making up 75% of all childhood cases. It affects the cells known as lymphocytes, which are a kind of white blood cell.
For someone diagnosed with ALL, it means that the bone marrow is releasing underdeveloped white blood cells which they call blast cells. When the number of these blast cells continue to release and increase, they eventually take over the number of red blood cells, causing both the red blood cells and platelets to decrease.
There are also two subtypes of ALL called B-cell and T-cell. For childhood cases of ALL, most of the cancer begins in the early formation of B-cells. While the T-cell normally affects older kids. A study released in a journal of National Center for Biotechnology Information (NCBI) shares that the majority of kids that have ALL are below 18 years of age, and normally between the ages of 2 and 10.
ACS also shares that kids under the age of 5 also have the highest risk of getting ALL, a risk that slowly declines once that person reaches his or her mid-20s. The outcome of kids suffering from ALL will depend on which subtype they have, their age and other specific factors each patient has.
2. Acute Myelogenous Leukemia (AML)
Acute myelogenous leukemia affects around 20% of all the children leukemia cases, most of them being acute in nature as well.
With AML, this type of leukemia affects white blood cells other than the lymphocytes, and can also affect the red blood cells and platelets.
AML can start in a number of areas including the myeloblasts, which turn white blood cells into granulocytes; the monoblasts that turn into white blood cells known as monocytes and macrophages; the erythroblasts that turn into red blood cells; and the megakaryoblasts, that turn into bone marrow cells known as megakaryocytes.
Juvenile Myelomonocytic Leukemia (JMML)
Juvenile myelomonocytic leukemia or JMML affects just 1% to 2% of all the cases of leukemia in children. It is considered an extremely rare type and it isn’t acute or chronic. This type starts in the myeloid cells, normally affecting children that are younger than 2 years old.
There symptoms may include fever, pale skin, easy bleeding or bruising, a cough, a rash, an enlarged liver, an enlarged spleen, difficulty breathing and enlarged lymph nodes.
What Are the Symptoms of Childhood Leukemia?
Oftentimes, the symptoms of childhood leukemia are nonspecific to the sickness, and are actually quite similar to other very common illnesses in children.
More often than not, a doctor will ask the parent how long their child has been experiencing certain symptoms. These symptoms could be rashes, coughing, both appetite and weight loss, swelling in the face and arms, swelling in the lymph nodes, pain and bleeding of the gums, vomiting, headaches, bone and joint pain, difficulty breathing, extreme weakness and fatigue, and seizures.
Some children even give specific symptoms, depending on which kind of blood cell is being affected by the leukemia.
For those with lowered red blood cells, their symptoms are pale skin, coldness, weakness, shortness of breath, dizziness or lightheadedness.
For those with lowered white blood cells, which also normally causes infections and fevers even without other signs of infections, a low platelet count may cause easy bruising, easy bleeding, bleeding gums, and frequent and severe nosebleeds.
Risk Factors for Childhood Leukemia
While there are a number of different factors that come into play that can possibly increase a child’s risk of leukemia, there are a number of genetic risks to watch out for. These genetic risks include Down syndrome, Li-Fraumeni syndrome, Wiskott-Aldrich syndrome, Bloom syndrome, Shwachman-Diamond syndrome. Another risk is if the child has another sibling that has been diagnosed with leukemia as well.
Other risk factors are environmental ones such as chemotherapy, radiation and benzene.
How Is Childhood Leukemia Diagnosed?
Depending on each child’s case, a doctor will ask them to undergo a series of examinations, tests and procedures. This can include blood tests, a physical exam, a biopsy, bone marrow aspiration and a number of other tests.
What Is the Treatment?
Again, depending on each child’s case and the type of leukemia they have, treatment can also vary depending on a number of different factors.
Treatment normally consists of two separate phases. The first phase will attempt to kill off the leukemia cells in the child’s bone marrow while the second phase will attempt to stop the cancer from coming back.
Here are the different types of treatment:
- Chemotherapy – This treatment uses a mixture of drugs to kill off the leukemia cells normally in tablets, drips or injections.
- Immunotherapy – This treatment involves immunotherapy medications which allows the body to attack and kill the leukemia cells.
- Targeted Drugs – This type of treatment is meant to target only the leukemia cells, killing them off without hurting the healthy cells.
- Radiation – This treatment uses high-energy rays to kill off the leukemia cells.
- Stem Cell Transplant – This treatment works to destroy the bone marrow and replace it with other stem cells via a transplant.
There are a number of possible complications that can occur in children undergoing treatment for leukemia. Just like with most patients, children normally require follow-up care depending on the side effects. Some of the side effects are complications with development and growth, learning, memory and thinking skills, psychological adjustments that might include mood, feelings and behaviors, function of the organs and tissues and even a risk of developing another type of cancer.
When To See a Doctor
Since the symptoms of leukemia often indicate other health issues in children, it’s hard to know exactly when to get in touch with a doctor. But if your child begins to show strange symptoms or behaviors that aren’t usually normal for them, bring them to their pediatrician right away. The hope is that it won’t be a life-threatening diagnosis but in case it’s more serious than you’d like, the earlier they get treatment, the better their chances of beating cancer.