Leukemia is a cancer in which abnormal white blood cells are produced in the bone marrow. These abnormal cells, called leukemia cells are cancerous. In other words, they grow out of control. Eventually they spill out of the bone marrow into the peripheral blood. The leukemia cells are not able to function as immune cells like other white blood cells, and their population keeps growing. Eventually they crowd out normal blood cells, including normal white blood cells, red blood cells, and platelets. There are so many leukemia cells that the normal blood cells cannot do their jobs of preventing infections, carrying oxygen, and causing the blood to clot. A child who has leukemia is infection-prone, looks pale, and bruises easily.
- More information on leukemias in general on the NCI web site. Note that you can toggle back and forth between “Health Professional” and “Patient” versions.
Types of Childhood Leukemia
There are different types of leukemia. These types are broadly classified as acute – gets worse quickly – or chronic – gets worse slowly. They are also grouped by the type of white blood cell that is affected: lymphoid or myeloid cells. Although all types of leukemia can occur in children, the most common types are Acute Lymphoblastic Leukemia, or ALL, and Acute Myeloid Leukemia, or AML. Adult leukemias (CLL, CML) are very rare in children. Two distinct types of myeloid leukemias are seen in children: JMML and APL.
|type (abbr)||full name of the leukemia||% of total leukemias||link to more info on the NCI site|
|ALL||Acute Lymphoblastic Leukemia||about 75%|
|AML||Acute Myeloid Leukemia||about 20%|
|JMML||Juvenile myelomonocytic leukemia*||rare|
|APL||Acute promyelocytic leukemia*||rare|
|CLL||Chronic Lymphoblastic Leukemia||rare|
|CML||Chronic Myeloid Leukemia||rare|
If you want to know about a type of leukemia that is not listed above, go to the NCI index page for all leukemias.
Symptoms of leukemia may include:
- lethargy, weakness, paleness, dizziness
- back, leg, and joint pain, headache, trouble standing or walking
- easy bruising, unusual bleeding, frequent nose bleeds, bleeding gums, petechiae (red pinpoints on the skin)
- repeated, frequent infections
- fever that lasts for several days, with or without an infection
- loss of appetite, weight loss
- swollen lymph nodes, bloated or tender stomach, swollen liver or spleen
- night sweats
- painless lumps in the neck, underarm, stomach, groin, around the eyes, or other parts of the body
Treatment for childhood leukemia depends on the type of leukemia and on prognostic factors that have been carefully determined by previous clinical trials. In general, childhood leukemias are treated with multi-agent chemotherapy including treatment of the central nervous system (CNS). Chemotherapy often includes steroids, vincristine, L-asparginase, methotrexate, 6-mercaptopurine, doxorubicin, cytarabine, and cyclophosphamide. Radiation and stem cell transplants are included in the treatment of some types of leukemia, especially in relapsed leukemia.
Clinical trials for leukemias can be found by searching the clinical trial database on the NCI web site. Follow these directions:
- Start at the NCI clinical trials search page.
- Choose type of cancer: “acute lymphoblastic leukemia (ALL), child.” You will be given more choices (e.g., type of cancer and type of trial): choose the appropriate responses and click “search.”
Treatment for Relapsed ALL
Two articles on relapsed ALL from CCCF Newsletters:
- Relapsed ALL: Questions for Parents to Ask (CCCF Newsletter, Spring/Summer 2007)
- Chemotherapy vs. Transplant as Treatment for Relapsed ALL (CCCF Newsletter, Fall/Winter 2007)
Future Hope for ALL
Scientists have identified mutations in a gene that predict a high likelihood of relapse in childhood ALL. This research was done as part of the NCI Therapeutically Applicable Research to Generate Effective Treatments (TARGET) initiative, and might lead to target therapies for the treatment of ALL
- NCI news release
- NEJM article abstract (published online January 7, 2009)
- NCI targeted therapies intiative (TARGET)
Future Hope for Myeloid Leukemia
An article by AML expert Dr. Robert Arceci entitled Myeloid Leukemias – Current and Future Approaches to Targeted and Individualized Therapies.
- Leukemias are the most common type of childhood cancer.
- Approximately 2,400 children and adolescents younger than 20 years diagnosed with ALL each year in the United States . There is a sharp peak in incidence of ALL and AML for 2-3 year olds.
- Survival rates for childhood ALL in first remission are now approaching 80%.
- Survival rates for children with AML is in the 40% range and remains one of the poorest of childhood cancers. Much work remains to be done to improve outcomes for this group of patients.
A good source of statistics is SEER fact sheet, which reports in detail the survival rates, incidence, and risk factors for childhood leukemias.
- Childhood Leukemia by Nancy Keene, available from American Childhood Cancer Organization.
- MD Anderson Cancer Center Children’s Cancer Hospital- MD Anderson’s website contains information on the symptoms, diagnosis, and treatment of childhood cancers. You can also find information about their Childhood Cancer Survivors Clinic, clinical trials, etc.
- Childhood ALL on the ped-onc resource center. (Information and links.)
- Childhood leukemias on the ped-onc resource center. (Information and links.)
- NIH site, MedlinePlus, links to useful information
- JMML Foundation The JMML Foundation was established to provide much needed support and information specifically for families affected by Juvenile Myelomonocytic Leukemia and for those who treat the disease.
E-mail Support Lists
- ACOR: ALL-kids
- ACOR: ALL-kids relapsed
- ACOR: BMT-talk (not childhood BMT specific, but a lot of parents of children are on the list)
- ACOR: AML (not childhood AML specific, but a lot of parents of children are on the list)
Yahoo list, JMML support