Leukemia is the most common type of cancer in children, accounting for nearly 30% of all pediatric cancers. It originates in the bone marrow, where blood cells are produced, and primarily affects white blood cells. These abnormal cells multiply uncontrollably, crowding out healthy cells and impairing the body’s ability to fight infection. This article provides an in-depth overview of the different types of leukemia in children, their symptoms, treatment options, and prognosis.
Understanding the types of leukemia in children is crucial for early diagnosis and effective treatment. With advances in medical research, the survival rate for children with leukemia has significantly improved, though outcomes vary depending on the type and stage of the disease. (Source)
What Is Leukemia?
Leukemia is a cancer of the blood and bone marrow. The bone marrow produces immature white blood cells that do not function properly, leading to various health complications. There are two primary types of white blood cells: lymphocytes and myeloid cells. Leukemia is categorized based on which type of white blood cell is affected and whether the disease progresses quickly (acute) or slowly (chronic). In children, acute forms of leukemia are more common. (Source)
Also, read: Now Know FAQs about Childhood Cancer
Types of Leukemia in Children
1. Acute Lymphoblastic Leukemia (ALL)
- Definition: Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in children, accounting for approximately 75-80% of cases. It affects immature white blood cells called lymphoblasts.
- Characteristics: ALL progresses rapidly, leading to a high number of immature white blood cells in the bone marrow and bloodstream. It primarily affects B-lymphocytes (B-cells) and T-lymphocytes (T-cells).
- Symptoms: Common symptoms include fever, fatigue, bone pain, frequent infections, easy bruising, and pale skin. Some children may also experience swollen lymph nodes or abdominal discomfort due to an enlarged liver or spleen.
- Diagnosis: Diagnosis is typically made through blood tests, bone marrow biopsy, and sometimes imaging scans. Lumbar puncture may be used to check for leukemia cells in the cerebrospinal fluid.
- Treatment: ALL treatment involves three phases: induction therapy (aimed at killing leukemia cells), consolidation therapy (preventing the return of leukemia), and maintenance therapy (long-term treatment to prevent relapse). Treatment may include chemotherapy, targeted therapy, radiation, and in some cases, stem cell transplantation.
- Prognosis: The survival rate for children with ALL has improved significantly, with long-term survival rates exceeding 90% in many cases, depending on factors like the child’s age, genetics, and response to treatment. (Source)
2. Acute Myeloid Leukemia (AML)
- Definition: Acute myeloid leukemia (AML) accounts for about 15-20% of childhood leukemia cases. It affects the myeloid cells, which normally develop into red blood cells, white blood cells (other than lymphocytes), and platelets.
- Characteristics: AML is a fast-growing leukemia that leads to the production of abnormal myeloblasts. This results in the overcrowding of healthy cells, causing issues with blood clotting and immunity.
- Symptoms: Symptoms of AML in children include fever, fatigue, infections, bleeding, frequent nosebleeds, bone or joint pain, and anemia. Enlarged lymph nodes, liver, and spleen can also occur.
- Diagnosis: AML is diagnosed through blood tests, bone marrow biopsy, and cytogenetic analysis to identify specific genetic mutations.
- Treatment: Treatment for AML typically includes aggressive chemotherapy and may also involve stem cell transplantation if the patient does not respond well to initial therapy or if there is a high risk of relapse. Radiation therapy may be used in rare cases.
- Prognosis: The prognosis for children with AML is less favorable compared to ALL, with survival rates around 65-70%. However, outcomes vary depending on the child’s response to treatment and the specific genetic characteristics of the leukemia. (Source)
3. Juvenile Myelomonocytic Leukemia (JMML)
- Definition: Juvenile myelomonocytic leukemia (JMML) is a rare and aggressive form of leukemia that occurs primarily in children under the age of 4. It arises from immature myeloid cells, affecting both white blood cells and monocytes.
- Characteristics: JMML falls between acute and chronic leukemias in terms of progression. It often causes overproduction of monocytes, a type of white blood cell, which leads to organ enlargement and blood abnormalities.
- Symptoms: Children with JMML may show signs of fever, skin rashes, anemia, bleeding issues, infections, and enlarged spleen or liver. There may also be swollen lymph nodes.
- Diagnosis: Diagnosis is made through blood tests, bone marrow examination, and specific genetic tests to identify mutations associated with JMML.
- Treatment: The primary treatment for JMML is hematopoietic stem cell transplantation (bone marrow transplant), which offers the best chance for long-term survival. Chemotherapy is less effective in JMML but may be used to control the disease before transplantation.
- Prognosis: JMML has a relatively poor prognosis compared to other forms of leukemia, with survival rates around 50%. Early diagnosis and timely stem cell transplantation improve outcomes. (Source)
4. Chronic Myeloid Leukemia (CML)
- Definition: Chronic myeloid leukemia (CML) is rare in children and accounts for less than 5% of pediatric leukemia cases. It affects the myeloid cells and progresses slowly compared to acute leukemias.
- Characteristics: CML is characterized by the presence of the Philadelphia chromosome, a specific genetic abnormality that leads to the overproduction of abnormal white blood cells.
- Symptoms: Early stages of CML may be asymptomatic or present with mild symptoms such as fatigue, weight loss, night sweats, and an enlarged spleen. As the disease progresses, more serious symptoms like anemia and infections can occur.
- Diagnosis: Diagnosis involves blood tests to detect high levels of white blood cells and genetic testing to identify the Philadelphia chromosome.
- Treatment: The treatment of CML in children involves targeted therapy with drugs like tyrosine kinase inhibitors (TKIs), which specifically target the abnormal protein produced by the Philadelphia chromosome. In some cases, stem cell transplantation may be considered.
- Prognosis: The prognosis for CML in children has improved significantly with the use of targeted therapies, with most children achieving long-term remission. However, CML requires lifelong management. (Source)
Symptoms of Leukemia in Children
Leukemia symptoms in children can be vague and easily mistaken for common childhood illnesses. Common signs include:
- Persistent fatigue or weakness
- Fever and frequent infections
- Easy bruising or bleeding (nosebleeds, bleeding gums)
- Bone or joint pain
- Swollen lymph nodes, spleen, or liver
- Weight loss or poor appetite
- Pale skin
- Shortness of breath
Parents and caregivers should seek medical attention if these symptoms persist or worsen. (Source)
Diagnosis of Leukemia in Children
Diagnosing leukemia typically involves several steps:
- Blood Tests: Complete blood count (CBC) to measure levels of different blood cells and identify abnormalities.
- Bone Marrow Biopsy: Extracting bone marrow samples to examine the presence of abnormal leukemia cells.
- Imaging Tests: X-rays, CT scans, and MRI scans may be used to assess organ enlargement or rule out other conditions.
- Lumbar Puncture: To detect leukemia cells in the cerebrospinal fluid, especially in cases where the disease has spread to the central nervous system. (Source)
Treatment Options for Childhood Leukemia
- Chemotherapy: The main treatment for leukemia in children, chemotherapy uses powerful drugs to kill leukemia cells and prevent their growth.
- Radiation Therapy: Used in specific cases, especially when leukemia has spread to the brain or central nervous system.
- Targeted Therapy: Particularly effective in types like CML, targeted drugs attack specific genetic mutations driving the leukemia.
- Stem Cell Transplantation: Used in high-risk or recurrent cases, this treatment involves replacing diseased bone marrow with healthy cells.
- Immunotherapy: A newer approach that uses the child’s immune system to target and destroy leukemia cells. (Source)
Also, watch web stories: 7 Facts You Need to Know about Childhood Leukemia
Conclusion
Leukemia in children is a complex disease with multiple subtypes, each requiring a specific approach to treatment. Acute lymphoblastic leukemia (ALL) is the most common and has a high survival rate with early and aggressive treatment. Acute myeloid leukemia (AML) and juvenile myelomonocytic leukemia (JMML), while less common, are more challenging to treat. Chronic myeloid leukemia (CML) is rare in children but has seen remarkable improvements in outcomes with targeted therapies. Early diagnosis and advancements in treatment have greatly improved the prognosis for many children with leukemia.
