Leukemia in Children and Teens

Leukemia is a cancer of the blood and bone marrow. It is the most common cancer in children and teens. About 3,500–4,000 new cases are diagnosed each year in the US. 

In leukemia, bone marrow does not work correctly. Bone marrow is the soft, spongy tissue in the center of most bones. It works like a blood cell factory. All blood cells start here. They begin as blood-forming stem cells.

In time, these stem cells turn into red blood cells, white blood cells, and platelets.

In a patient with leukemia, stem cells do not 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 to carry oxygen to the body’s organs
• White blood cells to fight infection and disease
• Platelets to make the blood clot

Leukemias are either acute or chronic. Acute means the symptoms develop quickly without treatment. Chronic means that the disease and symptoms develop slowly.

Acute leukemias are more common in children.

Signs 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
  
• Complete blood count test
  
• Bone marrow aspiration and biopsy
  
• Chest x-ray
  

Treatment of leukemia

Treatment depends on the type of leukemia. The most common treatment is chemotherapy.

Other treatments may include:

• Targeted therapy
• Immunotherapy
• Stem cell (bone marrow) transplant
  

Prognosis of leukemia

Doctors often use a number called the 5-year survival rate when talking about prognosis. This is the percentage of patients who live at least 5 years after their cancer diagnosis. 

With acute leukemias, children without the disease after 5 years are most likely cured. 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 for your child. 

Acute leukemias

The overall five-year survival rate for childhood acute lymphoblastic leukemia (ALL) is about 90%.  

The overall 5-year survival rate for childhood acute myeloid leukemia (AML) is 65-75%. 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%. But rates are lower for some other subtypes of AML.

Chronic leukemias

For chronic leukemias, 5-year survival rates are less helpful because children may live a long time with leukemia without being cured. In the past, 5-year survival rates for chronic myeloid leukemia (CML) were reported to be 60–80%. They are now much higher.