Written & Researched By: Trinity Nguyen
About Leukemia
Every day, children ranging from newborns to 15-year-olds are diagnosed with cancer that is a detriment to them and their families. They are cursed with the rather incurable and painful disease, some worse than others but it still causes a strain on every child. One of the most common cancers that are found in children is leukemia. 1 out of 285 children is diagnosed with leukemia and suffers greatly due to the symptoms. Some more common than others, the 6 different types of leukemia include:
Acute lymphocytic leukemia (ALL):
Affects the blood and bone marrow
Fast-growing
Goes for the lymph nodes
Acute myeloid leukemia (AML):
Blood and bone marrow
Fast-growing
Chronic myeloid leukemia (CML):
Begins in blood-forming cells of the bone marrow then progresses to the blood
Grows slowly
Chronic lymphocytic leukemia (CLL):
Starts at the bone marrow then moves to the blood
Grows slowly
Hairy cell leukemia (HCL):
Rare
Occurs when the bone marrow makes an excessive amount of B cells
Myelodysplastic Syndromes (MDS):
Occurs when too few functional red blood cells, white blood cells, and/or platelets are produced by the bone marrow
Progression of the disease varies
Of all of the six variations of leukemia, ALL (acute lymphoblastic leukemia) and AML (acute myeloid leukemia) are most commonly found in children. They are the most rapidly spreading and cause the most long-term damage, such as second cancers, heart and lung issues, learning issues, growth and development issues, fertility issues, bone problems, and social and emotional complications. All of these factors are experienced by leukemia patients regularly.
Acute lymphocytic leukemia is one of the most common and fatal in children. The name of the type of leukemia gives a brief description of what the disease actually does to the body. “Acute” explains that the disease grows rapidly, creating immature blood cells instead of mature blood cells. Lymphocytic means that the white blood cells also known as lymphocytes are affected. ALL has a high success rate for treatment and the chances of a cure are much higher. The main causes of ALL are when a bone marrow cell mutates the DNA.
What ALL does to the body:
ALL attacks the bone marrow and the cells within it. ALL tells the bone marrow cells to keep growing and dividing, which leads to an excessive amount of bone marrow cells. When this happens, it causes blood cell production to get out of control. They begin to produce immature blood cells that turn into white leukemic cells that are also known as lymphoblasts. These lymphoblasts do not function properly and get in the way of healthy cells. This type of cancer invades the bloodstream quickly and mutates within the bloodstream. The lymphomas from cancer mainly affect and spread to the lymph nodes, liver, spleen, and central nervous system. In order for the process to be defined as leukemia, cancerous lymphocytes must take up at least 20% of bone marrow matter. ALL is a type of cancer that if not treated immediately and correctly, it could get worse or possibly fatal.
Possible Risk Factors:
There are many risk factors that can lead to having leukemia as a child. One of the risk factors is exposure to x-rays before birth. Exposure to x-rays before birth is one of the leading causes of childhood cancer due to the high levels of radiation. Exposure to radiation is also a possible risk factor for leukemia relating back to x-rays. For children that have had cancer previously, past treatment with chemotherapy is also a risk as well. One of the major risk factors would be certain genetic conditions, such as down syndrome, type 1 neurofibromatosis, bloom syndrome, fanconi anemia, ataxia-telangiectasia, and Li-Fraumeni syndrome.
Risk Groups:
There are three risk groups that are used to determine the severity of the case.
Standard (low) risk:
This group includes children between the ages of 1-10
They have a white blood cell count of less than 50,000 during diagnosis
High risk:
Children 10 and older
White blood cell count more than 50,000 at the time of diagnosis
Very high risk:
Children under the age of 1
Children who have a slower response to initial treatment
Children who have signs of leukemia after the first 4 weeks of treatment
Standard Treatment:
Chemotherapy
Radiation therapy
Chemotherapy with stem cell transplant
Targeted therapy
*Clinical trials are also a form of “treatment” but the outcome of the trial is based on the patient and in some cases, it can cause more harm than good.
Throughout ALL treatment, three phases are followed each time to ensure the correct treatment for the patient. Stage 1 would be remission induction. Remission induction kills the leukemia cells in the blood and bone marrow and puts the cancer into remission. The second stage, consolidation and intensification, kills the remaining cells that may cause a relapse in the patient. The third and final stage would be maintenance. This phase kills the cells that may regrow. During this stage, smaller and lower doses are being used to make sure all of the cells are killed.
Infants with ALL use the same three plan treatments with a combination of chemotherapy. The infants are also given different anticancer drugs. Although stem cell transplants may be useful for patients at an older age, they could put a strain on the amount of time an infant patient has to live. Children that are over 10 years and adolescents with ALL have a different but similar treatment plan. They still use the three-phase plan with the combination of chemotherapy but are given more anticancer drugs. These drugs are given in higher dosages due to the size difference in the children.