Leukaemia in children: Understanding and Managing the Condition
Introduction
Leukaemia is a cancer that affects white blood cells, which are a component of blood. It can develop in children and teenagers and is the most common type of cancer observed in the younger population. White blood cells are produced in the bone marrow, along with other blood cells. Leukaemia also originates in the bone marrow and spreads through the bloodstream, replacing healthy white blood cells. Since white blood cells play a crucial role in defending the body against foreign organisms, individuals with leukaemia have a higher likelihood of developing infections and other health issues.
Types of Leukaemia
Leukaemia is categorised into three main types based on which type of white blood cells are affected and the rate at which the cancer progresses:
- Acute myeloid leukaemia (a rare cancer that affects the bone marrow and blood)
- Acute lymphocytic leukaemia (a type of cancer of the blood and bone marrow)
- Chronic myeloblastic leukaemia (an uncommon type of cancer of the bone marrow)
What are the Symptoms of Leukaemia in Children?
Since leukaemia begins in the bone marrow, the earliest symptoms are related to issues in the bone marrow. The most common symptoms of bone marrow at the early stage may include:
- Anaemia
- Fatigue or weakness
- Recurrent infections
- Bleeding or bruising easily
- Shortness of breath
- Bone and joint pain
- Swollen lymph nodes
- Abdominal swelling
Other symptoms of leukaemia in children and adolescents may include–
- Rapid loss of weight
- Loss of appetite
- Vomiting
- Coughing
- Rashes
- Headaches and seizures
- Vision problems
- Trouble balancing
- Gum problems
What are the Causes of Childhood Leukaemia?
Leukaemia, or cancer in general, occurs due to genetic mutations in the DNA of white blood cells, which prompt the cells to become abnormal in both shape and function. Deeper scientific exploration may lead to further discoveries regarding the nature of genetic degeneration that may contribute to the development of leukaemia, but the specific causes are not clearly understood. Nevertheless, certain risk factors may increase the likelihood of developing leukaemia in children.
What are the Risk Factors of Childhood Leukaemia?
The risk of childhood leukaemia increases significantly if a child has one or more of the following conditions:
- Down syndrome or Klinefelter syndrome
- Shwachman-Diamond syndrome
- Neurofibromatosis
- Fanconi anaemia
- Ataxia telangiectasia
- Exposure to radiation or radioactive substances
- Disorders of the bone marrow
- Cancer treatments such as chemotherapy, or radiation therapy
- A history of organ transplant
Although the risk is small, doctors recommend regular screening and testing for individuals with these risk factors to detect any abnormalities in blood cell production at an early stage.
Diagnosis of Leukaemia in Children
The early symptoms of leukaemia in children may lead to frequent visits to a doctor. After a complete medical and physical examination of the individual, several diagnostic tests may be performed to confirm or rule out leukaemia. These tests can assist doctors in identifying the type of leukaemia and determining how extensively it has spread. This extensive evaluation process can enable healthcare providers to tailor an appropriate treatment plan for patients.
The diagnostic tests required for evaluating patients may include the following:
- Complete Blood Count Test: The complete blood count (CBC) test is essential for providing valuable insights into the number, size, and stage of growth of all types of blood cells, including red blood cells, white blood cells, and platelets. Abnormalities detected during a CBC test may necessitate a further assessment of the blood cells.
- Bone Marrow Aspiration and Biopsy: A biopsy of the bone marrow, where white blood cells are produced, can help determine the type of cancer.
- Lymph Node Biopsy: Lymph nodes may assist in identifying the invasion of cancer, for which a biopsy on one or more lymph nodes may be required.
- Imaging Tests: Various imaging tests, such as X-rays, CT scans, MRI scans, and ultrasounds, may be performed on the organs and tissues to identify damage caused by leukaemia.
- Spinal Tap / Lumbar Puncture: A small amount of cerebrospinal fluid is removed from the spinal canal using a needle. This cerebrospinal fluid may help determine the presence of any infection or other issues.
How is Leukaemia Treated in Children?
The treatment for leukaemia in children and adolescents depends on several factors, including the patient’s age, overall health, medical history, the type of leukaemia, its stage, and the patient’s ability to tolerate treatment. Leukaemia cannot be staged conventionally; instead, patients are categorised into risk groups based on age and leukaemia type.
The primary objective of leukaemia treatment is to manage symptoms such as anaemia, bleeding, and infections. Common treatment modalities for leukaemia may include the following.
- Chemotherapy: High-dose medicines are administered via an intravenous line or orally. These medicines target abnormal blood cells inside the body and destroy them, thereby inhibiting their growth. Sometimes, the medicines may also be administered by a needle in a region near the spinal cord.
- Radiation Therapy: Special radiation energy, such as X-rays and gamma rays, is projected onto the target areas and can help relieve pain caused by swelling in the liver, lymph nodes, spleen, or due to bone marrow expansion.
- Bone Marrow/ Stem Cell Transplantation: After chemotherapy and radiotherapy treatments have been used to destroy cancerous cells in the bone marrow, new and healthy cells are needed to replace those cells. To achieve this, donor stem cells are utilised and put into the bloodstream intravenously. The stem cells can make their way into the bloodstream and start producing healthy blood cells.
- Immunotherapy: Immunotherapy helps patients fortify their immune system to fight against abnormal white blood cells. Immunotherapy drugs may also help direct radiation therapy and/or chemotherapy drugs to the bone marrow.
Other Treatments
There are other additional treatment modalities available which may be used for the treatment of leukaemia. These treatments may include the following.
- Blood transfusion: Blood transfusions may be used along with other treatments to help replace the blood cells other than WBCs.
- Medicines: Specific medicines may be given to manage the side effects of leukaemia treatment.
- Antibiotics: Antibiotic treatment may help to prevent and/or treat infections.
To treat leukaemia or any cancer for that matter warrants prompt diagnosis and treatment at an early stage. Oncologists at Giggles Hospital recommend regular screening tests to detect any abnormalities early on. To get the best-in-class medical services for comprehensive cancer treatment, book your appointment now and consult our experts.