CareTalk: Blog for Cancer and Blood Disorders
Get insights and inspiration from Nemours’ experts in Hematology/Oncology.
The term leukemia refers to cancers of the white blood cells (also called leukocytes or WBCs). Leukemias, as a group, make up about a quarter of all pediatric cancers. Luckily, with treatment, most children with leukemia will be free of the disease without it coming back.
Leukemias start in the bone marrow — the soft tissue found inside bones that produces blood cells. When a child is diagnosed with leukemia, it’s because the white blood cells in the body are producing abnormally. These cells (also known as blasts) start to crowd out the healthy cells in the bone marrow. Eventually, the healthy cells have no place to go, so they stop producing. When a child's body no longer produces enough healthy white blood cells it can cause anemia, swollen lymph nodes, and other symptoms of leukemia in children.
Leukemia is classified as being either acute (meaning it’s rapidly developing) or chronic (meaning it’s slowly developing). About 98% of pediatric leukemias are acute.
Although the symptoms of leukemia in each individual child can vary, common symptoms of leukemia in children include:
IMPORTANT NOTE: Instances of the symptoms of leukemia in children listed above, either together or on their own, do not automatically mean that a child has leukemia or any other kind of cancer. Any or all of these symptoms could be a sign of something else.
One of our Nemours pediatric hematologists-oncologists (doctors who treat blood disorders and cancers) will conduct a physical examination on your child to check for symptoms of leukemia in children such as signs of infection, anemia, abnormal bleeding, and swollen lymph nodes.
The doctor will also feel your child's abdomen to see if the liver or spleen is enlarged. We’ll also take a complete medical history by asking about your child’s symptoms, past health, your family's health history, any medications your child is taking, allergies, etc.
After this exam, the doctor will order a CBC (complete blood count) to measure the numbers of white cells, red cells, and platelets in your child's blood. Your child’s blood chemistries will also be checked.
Then, depending on what we find in the exam and blood tests, your child also may need a:
We know that tests can be scary – for you and your child. Whatever kind of tests your child might need, know that your Nemours pediatric leukemia care team will do everything we can to make the experience as comfortable as possible – physically and emotionally. We’ll give sedation or anesthesia as needed and offer support and guidance at every step.
Depending on your child’s age, overall health, extent of the disease, and other factors, treatment may include one or a combination of the following:
At Nemours, we know that getting a cancer diagnosis can be very frightening and overwhelming for your whole family. That’s why Nemours’ board-certified pediatric hematologists-oncologists, specialty nurses, cancer researchers, and other cancer experts are focused on helping not only your child, but your family, as well.
From diagnosis to treatment (and beyond) we’ll be here to help guide your family through your pediatric leukemia journey – and to strive and hope, with you, for a better tomorrow.
Leukemia is a type of cancer that affects the body's white blood cells (WBCs).
Normally, WBCs help fight infection and protect the body against disease. But in leukemia, WBCs turn cancerous and multiply when they shouldn't, resulting in too many abnormal WBCs, which then interfere with the body's ability to function normally.
In acute myeloid leukemia (AML), too many immature white blood cells (called myeloid blasts) are made. These leukemia cells are abnormal and cannot mature into normal white blood cells. This type of leukemia affects 20% of kids with this cancer of the blood cells.
Thanks to advances in therapy and clinical trials, the outlook for kids with AML is promising. With treatment, most are cured.
The cause of AML is unknown, though doctors know that certain medical conditions can increase a child's risk of getting AML. However, just because a child has a risk factor does not mean that he or she will get AML.
Risks include inherited genetic problems such as Down syndrome, neurofibromatosis type 1, Fanconi anemia, Noonan syndrome, and other inherited bone marrow failure syndromes (IBMFS). In addition, other non-inherited conditions such as preleukemia (also called myelodysplastic syndrome or MDS) and aplastic anemia can increase the risk of AML.
AML is also more common in kids who've been treated with chemotherapy or radiation. In fact, AML is the most common type of secondary cancer in children who have previously undergone cancer treatment.
In addition, a child with an identical twin who was diagnosed with leukemia before age 6 has a 20% to 25% chance of developing AML. Fraternal twins and other siblings of kids with leukemia have two to four times the average risk of developing it, too.
Certain environmental factors can predispose a child to leukemia. For example, exposure to radiation (such as X-rays) prior to birth may trigger the disease in a developing fetus.
AML is called "acute" because it tends to worsen quickly if left untreated. Chronic blood cancers, like chronic myelogenous leukemia (CML), tend to progress more slowly. However, the symptoms of all types of leukemia are generally the same and include:
Sometimes a child might have painless lumps that can be felt in the lymph nodes of the neck, underarm, or groin area. These lumps of leukemia cells (called chloromas) can develop anywhere in the body.
The subtypes of AML are classified according to the way the cells look under a microscope. If a doctor suspects leukemia, a child may undergo tests that include:
Because it can progress so quickly, there is no staging system for AML. Doctors generally characterize the disease as newly diagnosed or in remission.
Treatment is divided into two phases. The goal of the first phase, called induction, is to kill as many cancer cells as possible and achieve remission (a state where there is no evidence of disease in the body). The second phase (called post-remission, consolidation, or continuation therapy) is designed to eliminate any undetectable leukemia cells.
Phases I and II of treatment may include the following therapies alone or in combination:
Being told that a child has cancer can be a terrifying experience, and the stress of cancer treatment can be overwhelming for any family.
Although you might feel like it at times, you're not alone. To find out about support that may be helpful to you or your child, talk to your doctor or a hospital social worker. Many resources are available to help you get through this difficult time.
Reviewed by: Emi H. Caywood, MD
Date reviewed: March 2012