Leukemia in Children and Teens

What is Leukemia?

Leukemia is a cancer of the blood and bone marrow. It is the most common cancer in children and adolescents. About 3,500-4,000 are diagnosed with childhood leukemia in the U.S. each year.

Leukemia occurs when bone marrow does not work correctly. Bone marrow is the soft inner part of the bone. It functions like a blood cell factory. All blood cells start here. They begin as blood-forming cells (hematopoietic cells). If bone marrow works correctly, these blood-forming cells become cells that eventually turn into red blood cells, white blood cells, and platelets.

In a patient with leukemia, blood-forming cells don’t mature correctly. The blood produces too many immature blood cells or leukemia cells.

When this happens, the blood cannot do its job well. It does not have enough:

• Red blood cells –their job is to carry oxygen to the body’s organs. The person becomes very tired because of anemia.
  
• White blood cells – their job is to fight infection and disease. The person becomes ill.
  
• Platelets – their job is to make the blood clot. The person bleeds and bruises easily.

Leukemias are either acute or chronic. Acute means the symptoms develop fast. The disease will progress rapidly without treatment. Chronic means that the disease and symptoms develop slowly.

Acute leukemias are more common in children.

Signs and Symptoms of Leukemia

Signs and symptoms include: 

• Fever
  
• Frequent infections
  
• Weakness
  
• Fatigue
  
• Easy bleeding and bruising
  
• Pain in bones and joints

Diagnosis of Leukemia

• Physical exam and history
• Blood tests
  
• Bone marrow aspiration and biopsy
  
• Chest X-ray
  

Treatment of Leukemia

Treatment depends on the type of leukemia and its risk group. The most common treatment is chemotherapy.

Other treatments may include:

• Targeted therapy
• Immunotherapy
• Hematopoietic cell transplant (also known as bone marrow transplant or stem cell transplant)
  

Prognosis (Treatment Outlook) of Leukemia

When discussing cancer survival statistics, doctors often use a number called the five-year survival rate, the percentage of patients who live at least five years after their cancer is diagnosed. With acute leukemias, children without the disease after five years are most likely cured. That's because it is rare for these cancers to return after so long. Survival rates are only estimates. Your child’s doctor is the best source of information on the survival rate of your child’s particular case. 

Acute leukemias

The overall five-year survival rate for acute lymphoblastic leukemia (ALL) in children is approximately 90 percent.  

The overall five-year survival rate for children with acute myeloid leukemia (AML) is 65 to 75 percent. However, survival rates vary depending on the subtype of AML and other factors. For example, the cure rate for acute promyelocytic leukemia (APL), a subtype of AML, is now higher than 90 percent, but rates are lower for some other subtypes of AML.

Chronic leukemias

For chronic leukemias, five-year survival rates are less helpful because children may live for a long time with the leukemia without actually being cured. In the past, five-year survival rates for chronic myelogenous leukemia (CML) were reported to be in the range of 60 to 80 percent, but are now much higher.