Leukemia is a cancer that affects a type of blood cell. It develops in the bone marrow where blood cells are made. Leukemia makes the bone marrow create faulty white blood cells that do not work well. It can make it difficult for your body to fight infections. In addition, leukemia makes the marrow continues to make these blood cells even if there is not enough room for new cells. The leukemia cells build up in the bone marrow and make it difficult for healthy cells to grow.
There are different types of leukemia, but the two types that are most common in children are:
- Acute lymphoblastic leukemia (ALL)—creates an immature version of a white blood cell called lymphocytes. Will make the immune system weak.
- Acute myeloid leukemia (AML)—creates an immature version of a myeloid cell which normally develops into white blood cells, red blood cells, or platelets. Can lead to problems with the immune system, anemia, and bleeding problems.
White Blood Cells
Leukemia is causes by a problem with genes that determine how bone marrow cells work. It is not clear was causes the changes in the genes.
Factors that may increase a child's risk of leukemia include:
- Exposure to some environmental and chemical factors such as:
- Having a sibling, especially an identical twin, who develops leukemia
- Having a genetic condition, such as Down syndrome, Li-Fraumeni syndrome, Klinefelter syndrome, Wiskott-Aldrich syndrome, ataxia-telangiectasia, neurofibromatosis, Fanconi anemia
Common symptoms include:
- Bleeding or bruising—may appear as tiny red spots
- Recurrent infections—may have fever, chills, and a cough
- Bone and joint pain
- Abdominal pain
- Weight loss, loss of appetite
- Swollen lymph nodes, swelling of the liver or spleen
- Difficulty breathing
- Rash, gum problems
- Weakness and fatigue
- Pale skin
- Shortness of breath
- Decreased energy
These symptoms may be due to other conditions. If your child has any of these, talk to the doctor.
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor will check for swelling of the liver, spleen, and lymph nodes. Leukemia can be diagnosed by identifying abnormal blood cells in:
- Blood tests
- Bone marrow biopsy —a sample of bone marrow is removed to test for cancer cells
Imaging tests may be done to look for infections or injuries caused by leukemia including:
Symptoms created by leukemia may need to be treated first. Treatment may include:
- Antibiotics to treat infections
- Blood transfusion to treat severe anemia or bleeding
Treatment that targets the leukemia itself may one or a combination of the treatments below:
Chemotherapy is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells. May be used alone or with other treatments like radiation therapy.
Radiation is directed to a specific area to kill the cancer cells. May be used alone or with chemotherapy.
High doses of radiation and/or chemotherapy can destroy immature healthy blood cells. Transplantation will help the body build healthy cells again. Transplant options may include bone marrow or stem cell transplantation.
In bone marrow transplantation, the marrow may be removed, treated to kill cancer cells, and frozen. After treatment, the bone marrow is placed back into the body. The marrow may also be provided from a healthy donor. The marrow with leukemia will be removed and the donated marrow will be delivered after treatment.
Peripheral blood stem cell transplantation uses immature cells that are found in the blood. These cells are removed from the blood before chemotherapy or radiation treatment. Once treatment is done, the stem cells are then placed back into the blood. The immature cells will grow into healthy white and red blood cells.
- Biological therapy uses medication or substances made by the body to increase the body’s natural ability to fight cancer.
- Certain medication or therapies may also be used to help manage the side effects of treatment.
- During treatment and recovery your child may need to take steps to avoid infections. Treatments and the cancer can weaken the immune system and make the child more vulnerable to bacteria and viruses.
There is no known way to prevent childhood leukemia.
American Cancer Society
Leukemia and Lymphoma Society
Canadian Cancer Society
Team in Training
Leukemia and Lymphoma Society
Acute lymphoblastic leukemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 17, 2013. Accessed June 19, 2013.
Acute lymphoblastic leukemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 17, 2013. Accessed June 19, 2013.
Childhood Acute lymphoblastic leukemia Treatment. National Cancer Institute website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 6, 2013. Accessed June 19, 2013.
Childhood Acute myeloid leukemia Treatment. National Cancer Institute website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 4, 2013. Accessed June 19, 2013.
Leukemia. Leukemia and Lymphoma Society website. Available at: http://www.lls.org/diseaseinformation/leukemia/. Accessed June 19, 2013.
Leukemia. Lucile Packard Children's Hospital at Standford website. Available at: http://www.childrenshospital.org/az/Site1236/mainpageS1236P0.html. Accessed June 19, 2013.
Last reviewed December 2013 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.