Among all forms of leukemia which affect children, childhood leukemia is the most frequent one. It begins when bone marrow starts malfunctioning and thus producing dysfunctional blood cells in the bone marrow which crowd out normal blood cells. Even though it is more difficult for a child to face cancer, the good part is that children have a higher chance of defeating cancer if they get help at the right time. This is often a problem for poor families where children lose their chance of survival due to financial constraints. At Ketto, we give such families a platform to reach out to kind people and raise funds for treatment.
Cause of Childhood Leukemia
The causes behind childhood leukemia are not well understood, but there are some factors considered to increase the risk of cancer. However, for most of the cases of childhood leukemia, there are no well-understood risk factors.
The risk factors include:
- Children inheriting disorders like Li-Fraumeni syndrome, Down syndrome, or Klinefelter syndrome
- Those inheriting issues related to the immune system like ataxia-telangiectasia
- If a child’s sibling suffers from leukemia, especially the one who is also an identical twin
- If they have been heavily exposed to radiation, chemotherapy, benezene, or any other chemical similar in nature.
- If a child has got his immune system suppressed in the past. A likely example is organ transplant where immune system is suppressed to ensure that the body accepts the transplanted organ.
It is recommended by doctors that children with the above-mentioned risk factors get tests done to ensure that leukemia is diagnosed at an early stage.
Types of Childhood Leukemia
Majority of cases of childhood leukemia are not chronic but acute disease. It means that they grow and spread rapidly. There are a few cases of chronic and slow developing cases of leukemia.
Types of childhood leukemia include:
Acute lymphoblastic leukemia (ALL): It is also known as acute lymphocytic leukemia. 75% of the cases of childhood leukemia are acute lymphoblastic leukemia.
Acute myelogenous leukemia (AML): After ALL, the next biggest share in terms of commonality is of acute myelogenous leukemia.
Hybrid or mixed-lineage leukemia: It is a rare form of childhood leukemia. It carries the characteristics of ALL as well as AML.
Chronic myelogenous leukemia (CML): This form of childhood leukemia is not very common.
Chronic lymphocytic leukemia (CLL): This a very rare form of childhood leukemia.
Juvenile myelomonocytic leukemia (JMML): This occurs to children who are less than 4 years in age. It is also a rare type of leukemia and cannot be categorized as acute or chronic in nature.
Symptoms of Childhood Leukemia
In the cases of childhood leukemia, symptoms often occur earlier than in the case of adults. This increases the chances of detection of cancer when it is in an early stage.
The symptoms are as follows:
- The child may feel extremely fatigued all the time
- Skin may begin appearing pale in color
- The child may become more prone to infectious diseases
- Fever may occur frequently
- Body may get easily bruised which may result in bleeding which may result in prolonged bleeding
- Breathing may become difficult and marked by short breaths
- The child can often be seen coughing
- Pain in bones and bone joints may occur
- Swelling may occur in various parts of the body like face, sides of neck, arms, underarms, groin, abdomen, and collarbone
- There can be an apparent decrease in hunger which may lead to weight reduction
- Frequent headaches and unexplained seizures
- Problems in maintaining balance while sitting, standing, or walking
- Problems with eyesight
- Unexplained vomiting
- Rashes anywhere or all over the body
- Problems with gums like pain or bleeding
Diagnosing Childhood Leukemia
Diagnosis begins with a thorough review of medical history by a doctor who then conducts a physical examination. Based on the results, he may conduct further tests to confirm his findings.
Initial tests may include:
- The first test could be a blood test to measure if the number of different types of blood cells fall within the normal range or not.
- A lack of enough number of blood cells may prompt your doctor to conduct bone marrow aspiration. In this process, a biopsy is taken from the pelvic bone and tested for cancerous blood cells to diagnose leukemia.
- The next step could be to check if the cancer appears to have metastasized. To check if it has affected the brain, spinal cord, and other regions around them, the doctor may conduct a test called lumber puncture or spinal tap. This test helps in diagnosing whether the cancerous cells of leukemia have reached the brain fluid or not.
- To determine the type of childhood leukemia, the doctor may prescribe few other types of tests.
- Some tests might be conducted to determine the treatment method to go with.
- While the treatment is going on, pathologists may conduct tests to diagnose if the treatment is helping the patient or not.
Treatments for Childhood Leukemia
Fight against cancer is long and difficult. As the treatment can last years, it can affect the mental and emotional status of the patient. So, it is important that you establish a clear path of communication with your child as well as the team taking care of him. The treatment procedure will be recommended on the basis of various factors like your child’s health, medical history, type of leukemia, etc.
Through extensive research and development in the field of cancer treatment, survival rates have significantly improved. Now many specialise centres are available that take special care of children and teenagers suffering from cancer. Children also have an advantage that their body fights cancer better than the body of adults.
Cancer symptoms are generally a result of other problems caused by the cancer. Therefore, children often need treatment for those problems before they can undergo treatment for cancer. For example, the reduction in WBCs can make them more prone to infections. Reduction in platelets can result in easy bruising and severe bleeding. Lack of enough number of RBCs can lead to a reduction in the quantity of oxygen reaching the cells and tissues in the body.
The treatment to all these problems includes the use of antibiotics, blood transfusion, and other ways to tackle infection.
The most common form of treatment prescribed for children is chemotherapy. These drugs can be given to your child either orally or through intravenous injections. Even if the chemotherapy succeeds in sending the cancer into remission, the child can still be asked to undergo chemotherapy as part of his/ her maintenance therapy. This therapy may be given in cyclical form for up to 3 years.
In some cases, your child may be prescribed a targeted therapy. If the cancer is in an early stage and has not spread much in the body, this treatment can be used effectively. It has less adverse side-effects compared to chemotherapy.
Another option is the use of radiation therapy. In this therapy, high-energy radiation beams are used to kill cancerous cells and mitigate tumours. It is also used as a preventive treatment after leukemia has been cured.
Surgical procedures to remove the cancer is rarely prescribed to children in cases of leukemia.
Stem Cell Transplant
If chemotherapy and radiation therapy fail to do there job effectively, the next option given to patients is stem cell transplant. But before the transplant, the child’s bone marrow is completely destroyed through high doses of chemo and radiation therapy so that the transplanted bone marrow does not become infected from cancer.
A new treatment method recently approved by FDA is gene therapy. When other treatment methods fail to show any good result in case of B-cell ALL, doctors may prescribe gene therapy to the patient. Currently, patients up to the age of 25 are only allowed to take this treatment. Research is still going on to make this treatment method of leukemia accessible to those above 25 years in age.
CAR T Cell Therapy
In this form of therapy, some of the immune cells (also called T cells) are genetically modified so that they identify and kill cancerous cells of the body. Genetic modifications to the T-cells are done by removing a few samples from the patient’s blood stream and inserting new genes in the cells with help of a virus. The new cells are made to grow and multiply in the lab. Then all such cells are inserted back in the body of the patient. However, this method only works if there is specific region or very specific types of cancerous cells to target.