Leukemia in children the most important causes symptoms and treatment methods

Childhood leukemia is one of the conditions that worries every parent, as it affects the production of healthy blood cells and weakens the immune system. In this article, we’ll discuss the causes of leukemia in children, the key symptoms you should watch for, and the latest treatment options, including medications, chemotherapy, and surgery. If you want to understand all the details step by step and learn how to protect your child and improve their chances of recovery, Daleeli Medical will help you understand the condition and take prompt action for your child’s health.

Causes of Leukemia in Children؟

1️⃣ Genetic and Hereditary Factors
Some mutations in the DNA cause blood cells to grow abnormally.
Certain genetic conditions increase the risk, such as:

Down syndrome
Bloom syndrome or Li-Fraumeni syndrome

2️⃣ Bone Marrow Problems
The bone marrow is responsible for producing blood cells.
Any disruption in production or cell division can turn some cells into cancerous ones.

3️⃣ Exposure to Radiation or Chemicals
Prolonged exposure to radiation or certain chemicals like benzene may increase the risk.
Although this is very rare in children, it can be a factor in some cases.

4️⃣ Environmental or Acquired Factors
Exposure to certain medications or chemotherapy at a young age may sometimes increase the risk later.
However, most children with leukemia have no clear cause; random genetic mutations are often responsible.

5️⃣ Weak Immune System
Children with a weak immune system, whether congenital or acquired, may be more susceptible to developing leukemia.

Symptoms of Leukemia in Children

Leukemia affects the bone marrow, which produces red blood cells, white blood cells, and platelets. When leukemia cells (blasts) multiply rapidly, they compete with healthy cells, causing noticeable symptoms.

Key symptoms in children include:

1️⃣ Anemia

Reduced red blood cell production due to bone marrow overcrowding.
The child may appear pale, tired, and breathe faster to compensate for low oxygen levels.

2️⃣ Bleeding & Bruising

Low platelet count makes the child more prone to bleeding and bruises.
Small red spots on the skin (petechiae) may appear.

3️⃣ Frequent Infections

Even if white blood cells are high in number, they are immature and cannot protect the body effectively.
Children may experience recurring fever, runny nose, cough, or infections.

4️⃣ Bone & Joint Pain

Bone marrow overcrowding can cause pain in the bones and joints.

5️⃣ Abdominal Pain

Cancer cells can accumulate in the liver, spleen, or kidneys, causing swelling, pain, and loss of appetite.

6️⃣ Swollen Lymph Nodes

Lymph nodes in the armpits, groin, neck, or chest may swell due to cancer cell accumulation.

7️⃣ Difficulty Breathing

In T-cell acute lymphoblastic leukemia (T-ALL), cells may gather around the thymus behind the chest bone.
Symptoms can include shortness of breath, wheezing, or coughing and require urgent medical attention.

⚡ Important Note:

Symptoms of ALL or AML appear suddenly within days or weeks.
Symptoms of chronic leukemia (CML) develop gradually over months or years.
Symptoms may resemble other conditions, so it is crucial to consult a pediatrician promptly for accurate diagnosis.

Childhood Leukemia: Malignant or Benign? Who Is Most at Risk?

Leukemia is a type of malignant cancer that affects the bone marrow and blood, causing abnormal growth of white blood cells that interferes with the production of healthy cells. All types of leukemia are classified as malignant, whether acute or chronic, and require specialized treatments such as:

Chemotherapy
Immunotherapy
Bone marrow transplantation

Who Can Develop Leukemia in Childhood?

Leukemia is the most common type of cancer in children, even though it is rare in adults.

It accounts for about 28% of all childhood cancers.
In the United States, approximately 5 out of every 100,000 children are expected to be diagnosed with leukemia each year.

❓ What Causes Childhood Leukemia?

The exact cause is still unknown.
There is no guaranteed way to prevent it, and most cases are due to random genetic mutations or limited environmental factors.

Stages of Childhood Leukemia

1️⃣ Initial Stage – Disease Onset

Abnormal white blood cells begin multiplying rapidly in the bone marrow.
These cells are immature and do not function properly.

Early symptoms:

Severe fatigue and paleness
Frequent fever or infections
Easy bruising or bleeding
Loss of appetite or weight

2️⃣ Acute Stage – Disease Progression

Leukemia cells multiply and start occupying the bone marrow, reducing the production of healthy cells.

Symptoms:

Anemia
Low platelet count (bleeding problems)
Weak immune system (susceptibility to infections)

Possible spread to:

Lymph nodes
Liver and spleen
Sometimes the brain or cerebrospinal fluid (CNS)

3️⃣ Treatment & Correction Stage

After diagnosis, the child receives treatment based on the type of leukemia:
- Chemotherapy
- Sometimes radiation therapy or bone marrow transplant
Goal: Eliminate leukemia cells and restore normal blood cell production

4️⃣ Recovery & Follow-up Stage

Post-treatment, the child requires long-term follow-up to monitor:
- Return of blood cells to normal levels
- Any signs of relapse
- Immune system health and overall growth

Types of Childhood Leukemia

1️⃣ Acute Lymphoblastic Leukemia (ALL)

Most common type in children.
Starts in lymphocytes (a type of white blood cell).

Symptoms:

Severe fatigue
Pale skin
Easy bleeding or bruising
Enlarged lymph nodes, liver, or spleen
Recurrent fever or infections

2️⃣ Acute Myeloid Leukemia (AML)

Begins in myeloid cells, which produce red blood cells, white blood cells, and platelets.
Less common than ALL in children, but more severe.

Symptoms:

Severe fatigue and obvious paleness
Nosebleeds or gum bleeding
Bruises or red spots on the skin
Recurrent fever or infections

3️⃣ Chronic Leukemia (CML – rare in children)

Develops slowly compared to acute leukemia.

Symptoms:

Enlarged liver and spleen
Chronic fatigue
Weight loss or loss of appetite

Survival Rate of Childhood Leukemia

Recent studies show that childhood leukemia has a relatively high survival rate, reaching about 85% overall.
For the most common type of leukemia, the survival rate ranges from 90% to 95%.

Chemotherapy:

Chemotherapy is the cornerstone of treating childhood leukemia. It works by killing active cancer cells and achieves excellent results.

However, it can also affect normal cells, such as hair cells, which may lead to hair loss.
To minimize side effects, doctors have developed more targeted therapies that attack cancer cells specifically without harming healthy cells.

Survival Rates by Type:

1️⃣ Acute Lymphoblastic Leukemia (ALL):

5-year survival rate: about 90%

2️⃣ Acute Myeloid Leukemia (AML):

Recovery rates range between 65–70%, varying by subtype and other factors

3️⃣ Juvenile Myelomonocytic Leukemia (JMML):

5-year survival rate: about 50%, the lowest among common types

4️⃣ Chronic Myeloid Leukemia (CML):

Rare in children, with 5-year survival rates ranging from 60–80%

✅ These rates show significant progress in treating childhood leukemia, especially with early diagnosis and careful follow-up.

Diagnostic Tests for Childhood Leukemia:

Accurate diagnosis requires a combination of laboratory and imaging tests, including:

1️⃣ Complete Blood Count (CBC) and Body Function Tests:

Measures red and white blood cells and platelets
Kidney and liver function tests assess organ health before treatment
Uric acid levels are measured to detect harmful accumulation
Blood smear under a microscope checks for potential cancer cells

2️⃣ Bone Marrow Biopsy:

The most common test to determine leukemia type
Helps assess the percentage and type of cancer cells precisely

3️⃣ Spinal Tap (Lumbar Puncture):

Detects cancer cells in cerebrospinal fluid surrounding the brain and spinal cord

4️⃣ Cytogenetic Analysis:

Studies chromosomes in blood, bone marrow, or lymph node cells
Helps identify genetic problems linked to leukemia, such as the Philadelphia chromosome in CML

5️⃣ Molecular Tests:

PCR (Polymerase Chain Reaction): Detects tiny traces of cancer cells in the body
FISH (Fluorescence In Situ Hybridization): Identifies chromosomal abnormalities in cell DNA

✅ Together, these tests give doctors a clear picture of the leukemia type and stage, helping them choose the most appropriate treatment for each child.

Supporting Parents of Children with Leukemia:

A child’s leukemia diagnosis is extremely challenging for parents, as they face emotional and psychological pressures alongside practical challenges of treatment and care. Providing comprehensive support is crucial.

1️⃣ Psychological and Emotional Support:

Parents often experience fear, anxiety, sadness, or guilt
Counseling services and support groups help them express emotions in a safe environment
Connecting with other families who have gone through similar experiences provides reassurance and allows sharing of advice and experiences

Duration and Main Stages of Childhood Leukemia Treatment

The duration of leukemia treatment in children varies depending on the case, but it usually ranges from 2 to 3 years. Treatment is generally more intensive in the early months to eliminate as many cancer cells as possible. The treatment is divided into three main stages:

1️⃣ Remission Induction

Description: The first stage of leukemia treatment.
Goal: Kill cancer cells in the blood and bone marrow to achieve remission.
Notes: This stage is usually intensive and relies on strong chemotherapy.

2️⃣ Consolidation/Intensification

Description: Begins after successful induction, once the leukemia is in remission.
Goal: Eliminate any remaining cancer cells that could cause relapse.
Methods: High-dose chemotherapy, and in some cases, radiation therapy or stem cell treatment.

3️⃣ Maintenance

Also known as: Continuation phase.
Goal: Kill any residual leukemia cells and prevent disease recurrence.
Methods: Lower-dose chemotherapy compared to the first two stages.
Note: Strict adherence to the doctor’s instructions is essential to reduce the risk of relapse.

✅ Summary: Treatment for childhood leukemia is relatively long but structured in stages to maximize the chances of cure and minimize recurrence.

Treatment Methods for Childhood Leukemia

Treatment depends on the type of leukemia, the child’s overall health, and how the body responds to therapy. Key treatment options include:

1️⃣ Chemotherapy

The main treatment for childhood leukemia.
Can be administered as oral pills, intravenous injections, intramuscular injections, or into cerebrospinal fluid.
Usually divided into four phases:
- Remission Induction: Kill as many leukemia cells as possible to achieve remission.
- CNS-Directed Therapy: Kill cancer cells in the brain or spinal cord to prevent spread.
- Consolidation/Intensification: High doses to eliminate remaining cancer cells.
- Maintenance: Lower doses to maintain results and prevent relapse, lasting 2–3 years.

2️⃣ Radiation Therapy

Uses high-energy rays to destroy cancer cells.
Typically used in specific cases, such as:
- Spread to the brain or spinal cord
- Testicular involvement
- High-risk cases where disease may spread
The most common form in children is external beam radiation.

3️⃣ Bone Marrow / Stem Cell Transplant

Used for treatment-resistant or recurrent leukemia.
Goal: Replace diseased bone marrow with healthy stem cells after eliminating cancer cells.
Types of Transplants:
- Allogeneic: Stem cells from a compatible donor
- Autologous: Stem cells taken from the child before treatment