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Treatment for Childhood Leukemia

Treatment for Childhood Leukemia

What is the Treatment for Childhood Leukemia?

The majority of children diagnosed with childhood leukemia will be treated with chemotherapy. Chemotherapy (often simply called “chemo” for short) involves targeting cancerous cells with specific drugs. The specific type of drugs, their dosages, and the duration of the treatment will be unique to each patient, depending on the type and classification of leukemia, the cancer’s classification of risk, and the specific needs of each child. Surgery and radiation are not commonly utilized in the treatment of childhood leukemia, although they may be required to address specific health issues in certain cases. Because chemotherapy can have significant short- and long-term health effects on childhood leukemia survivors, researchers are continuing to investigate new and less toxic treatments such as immunotherapy and targeted chemotherapy; however, these treatments are still in the research phase.

Because AML and ALL are the two most common types of childhood leukemia, this discussion will focus specifically on their treatment.

Chemotherapy for ALL

pediatric ChemotherapyTreatment for children with Acute lymphocytic leukemia (ALL) usually involves smaller dosages of chemotherapy but spread over a period of two-to-three years (boys often receive treatment for longer than girls, due to a higher risk of recurrence). For most children with ALL, chemotherapy will involve three distinct phases:

  • Induction: The goal of induction is to kill 99% of existing cancer cells and achieve “remission”, in which no cancer cells are found in the bone marrow and blood counts return to normal (this is not, however, the same as a “cure”). Induction usually lasts about one month and is extremely intense, requiring prolonged hospital stays and frequent visits to the doctor. Induction almost always includes intrathecal chemotherapy, in which the chemotherapy is targeted at the cerebrospinal fluid to kill any cancer cells that may have spread to the brain and/or spinal column.
  • Consolidation (intensification): This phase usually lasts for 1-2 months and is designed to reduce the number of cancer cells remaining in the body, as well as fight the potential for drug resistance among those cancer cells. This phase is also highly intense (often more so than induction).
  • Maintenance: About 95% of children with ALL will achieve remission after induction and consolidation. For these children, an additional 2 years of so-called maintenance chemotherapy will help prevent the disease from recurring. Maintenance is much less intensive, and usually involves the administration of chemotherapy for brief periods every 4-8 weeks. The early part of maintenance may involve 1-2 months of intensified treatments called re-induction or delayed intensification.

Chemotherapy for AML

Chemotherapy for AML is more intensive, involving higher dosages of treatment drugs but over a shorter duration. Chemotherapy for AML includes an induction phase and a consolidation (intensification) phase, but usually lacks a maintenance phase.

  • Induction: Induction for AML usually involves the administration of drugs for several days in a row, with treatments scheduled every 10-14 days. Less time between treatments is generally more effective but can lead to more severe side effects. Each treatment plan will depend on the child’s unique disease progression and their reaction to the chemotherapy. Treatment will continue until the bone marrow is clear of leukemia cells, usually after 2-3 treatment cycles. As with ALL, treatment usually involves intrathecal chemotherapy as well.
  • Consolidation (intensification): Between 85-90% of children with AML will achieve remission after the induction phase. Consolidation usually involves several more months of intensive chemotherapy, as well as intrathecal chemotherapy. In some cases, a stem cell transplant from a sibling may be appropriate as well, especially for children with high risk AML.

Although the duration of treatment is shorter for AML, it requires extensive supportive care and attention to ancillary issues such as nutrition, medication, and blood transfusions to cope with the more severe side effects, including (but not limited to) damage to the bone marrow responsible for creating new blood cells.

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About American Childhood Cancer Organization

American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer.  And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.


For additional information about childhood cancer or on the ACCO, or to order resources for you or your child, please visit our website at , call 855.858.2226 or visit:

Signs and Symptoms of Childhood Leukemia

About Childhood Leukemia (ALL & AML)

leukemiaChildhood leukemia—a blood-based cancer in which abnormal cancer cells grow in the bone marrow—is the most common type of childhood cancer, accounting for almost one-third of all childhood cancer diagnoses. There are three different types of childhood leukemia. The most common type—Acute lymphocytic (lymphoblastic) leukemia, or ALL, accounts for approximately 3 out of 4 cases of childhood leukemia. ALL stems from abnormal cells growth in immature lymphocytes, the white blood cells that help the body fight infection. Acute myelogenous leukemia (AML) accounts for about one out of four cases of childhood leukemia. AML begins with abnormal growth of myeloid cells, which are responsible for the development of non-lymphocytic white blood cells, red blood cells, and platelets. A third type of childhood leukemia—Juvenile myelomonocytic leukemia (JMML)—is extremely rare. Like AML, it develops in the myeloid cells. It is acute (quickly growing) but it does not develop and spread as quickly as AML or ALL.

Symptoms of Childhood Leukemia

Childhood leukemia begins in the bone marrow (the soft core within the bone responsible for the development of blood cells, including red blood cells, white blood cells, and platelets), quickly spreading into the blood stream and potentially crowding out healthy cells our body needs to properly function. Once in the blood stream, cancer cells begin to travel throughout the body and can impact the health of other organs. The symptoms of leukemia often depend on the type of blood cell impacted by the cancer, and whether the cancer has begun to impact other organs.

Red blood cells: Red blood cells are responsible for carrying oxygen from the lungs to every cell in the body. If childhood leukemia has caused a shortage of healthy red blood cells, symptoms can include:

  • Unusually pale skin
  • Fatigue
  • Weakness
  • Shortness of breath
  • Headaches
  • An unusual sensation of cold
  • Feeling lightheaded or dizzy

White blood cells: White blood cells help the body fight off illness caused by viruses and/or bacteria. If childhood leukemia has caused a shortage of white blood cells, or prevents the white blood cells from functioning properly, your child may not be able to fight infection properly. Recurring infections or infections that won’t go away even with medical intervention may indicate the presence of leukemia. Fever is usually the main indicator of an infection.

Platelets: Platelets are responsible for helping create blood clots in order to control and stop bleeding. If childhood leukemia has caused a shortage of platelets, symptoms can include:

  • Easy and frequent bruising
  • Easy bleeding
  • Frequent and/or severe nosebleeds
  • Bleeding gums

As childhood leukemia spreads from the blood stream into various other organs of the body, it can cause symptoms relating to specific organs, including:

  • Bone or joint pain
  • Swollen lymph nodes
  • Swelling in the abdomen caused by the build-up of cancer cells in the liver and/or spleen
  • Weight loss/loss of appetite caused by swelling abdominal organs pressing on the stomach
  • Coughing or trouble breathing caused by the build-up of cancer cells near or in the lungs
  • Headaches, seizures, vomiting, loss of balance, and blurred vision could be indications that leukemia cells have begun to accumulate in the brain and spinal cord
  • Swelling of the face and arms—SVC syndrome—a potentially very serious symptom caused by the build-up of cancer cells in the thymus, leading to pressure on the blood vessel moving blood between the head and arms
  • Symptoms more common in children with AML include skin rashes, gum problems (swelling, pain, and bleeding), extreme weakness, extreme tiredness, and slurring of speech

With the exception of serious symptoms such as SVC syndrome and the extreme fatigue and weakness sometimes (although rarely) seen in patients with AML, the most common symptoms of childhood leukemia are also symptoms of many routine childhood illness. Childhood leukemia is a very rare disease, and the presence of one or more of these symptoms does not mean that your child has leukemia. However, it is important to have your child examined by a pediatrician, who will suggest additional diagnostic testing if he or she suspects that the symptoms may be related to childhood leukemia.

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