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Causes, Risk Factors, and Prevention of Childhood Leukemia Cancer

Tag Archives: Childhood Leukemia

What Causes Childhood Leukemia?

Causes Childhood Leukemia bonesBoth major types of childhood leukemiaAcute lymphocytic (lymphoblastic) leukemia (ALL) and Acute myelogenous leukemia (AML)—begin in the bone marrow, the soft inner part of the bone where new blood cells are created. As the leukemia cells accumulate inside the bone marrow, they overwhelm the healthy cells, eventually spreading into the blood stream. Thus, leukemia is a blood-based cancer, and must not be confused with other types of childhood cancers that start in other parts of the body and eventually spread into the bone marrow.

Why do some blood cells in children grow into abnormal leukemia cells? In other words, what causes childhood leukemia? Unfortunately, we cannot yet answer that question. We do know that childhood leukemia, like most other childhood cancers, is not caused by environmental or lifestyle factors. Absent these factors, scientists and researchers do not know what causes certain cells within a child’s bone marrow to begin growing and functioning abnormally.

Increasingly, scientists are beginning to believe that many childhood cancers, including leukemia, are linked to mutations—or random, uncontrolled alterations—to the DNA found within normal bone marrow cells. Leukemia may be connected to a specific type of DNA mutation controlling the genes responsible for ensuring that cells divide, grow, replicate, and die properly. Another potential cause of childhood leukemia may be a form of genetic mutation called chromosome translocation, where DNA from one chromosome breaks off and becomes attached to a different chromosome. Again, if this mutation affects oncogenes and/or tumor suppressor genes, it may lead to the development of childhood leukemia or other types of childhood cancer.

What are the risk factors for childhood leukemia?

If it is true that genetic mutations are responsible for most cases of childhood leukemia, it is important to note that these genetic mutations are usually the result of random and unpredictable changes and are not linked to any known or inherited risk. However, there are a few inherited conditions which may result in a higher risk factor for some rare cases of childhood leukemia, such as:

  • Inherited syndromes such as Down syndrome (trisomy 21) and Li-Fraumeni syndrome
  • Inherited immune system problems such as Ataxia-telangiectasia, Wiskott-Aldrich syndrome, Bloom syndrome, and Schwachman-Diamond syndrome
  • Having a sibling with leukemia, especially if the sibling is an identical twin

The one environmental factor that may pose an increased risk of childhood leukemia is exposure to extremely high levels of radiation (such as Japanese survivors of the 1945 atomic bombings). However, scientists are exploring any potential links between childhood leukemia and smaller dosages of radiation (like routine x-rays), as well as chemotherapy and exposure to toxic chemicals.

Can Childhood Leukemia Be Prevented?

Although we don’t yet know definitively what causes childhood cancer, we can say definitely that there is no way to prevent it, or as of right now, screen for it the way we can with many adult cancers. We can hope that as our understanding of the causes of leukemia and other childhood cancers improves, that knowledge brings with it a better understanding of how to detect the disease before it becomes the terrible threat that it poses today.

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 www.acco.org , call 855.858.2226 or visit:

Childhood Leukemia

i-Czgv5NRNearly one-third of all children and teens with cancer are diagnosed with childhood leukemia, making this form of childhood cancer by far the most common. Childhood leukemia is a cancer of the blood. It begins in the bone marrow, the soft interior of the bones responsible for the development of new blood cells. Leukemia cells in the bone marrow replicate more quickly than healthy cells, and do not die at the proper time, and eventually begin to crowd out healthy cells. As this happens, the cancerous cells enter the blood stream and quickly move around the body. As the leukemia cells invade other organs, they begin to impact the ability of those organs to function normally.

There are two main types of acute childhood leukemia: ALL and AML:

  • Acute lymphocytic (lymphoblastic) leukemia (ALL): ALL is the most common form of childhood leukemia, accounting for approximately 75% of leukemia diagnoses. ALL develops from immature lymphocytes, which when healthy grow into white blood cells responsible for fighting infections and bacteria. Most ALL cases involve B cells, the lymphocytes responsible for making the antibodies that the body uses to fight viruses; however, some cases of ALL originate in T cells, which are responsible for fighting infection themselves.
  • Acute myelogenous leukemia (AML): Approximately 25% of childhood leukemia cases are AML, also known as acute myeloid leukemia, acute myelocytic leukemia, or acute non-lymphocytic leukemia. AML originates in myeloid cells that are responsible for developing non-lymphocytic white blood cells, red blood cells, and platelets.

Juvenile myelomonocytic leukemia (JMML) is a very rare type of childhood leukemia that is usually diagnosed in children under the age of 4. Like AML, it originates in myeloid cells, but develops much more slowly than AML (yet still grows more rapidly than chronic leukemia common in adults). Chronic (slow-growing) leukemias such as chronic myelogenous leukemia (CML) and chronic lymphocytic leukemia (CLL) are extremely rare in children.

Detection and Diagnosis of Childhood Leukemia

Children are usually diagnosed with childhood leukemia once it has entered the blood stream and spread to other parts of the body, leading to visible symptoms of illness as the leukemia cells prevent the normal functioning of various organs. The most common symptoms of childhood leukemia are fatigue, headaches, paleness, fever, and infection. Of course, these are similar to symptoms of many routine childhood ailments; however, your child’s pediatrician may recognize them as potential warning signs of leukemia if they persist, reoccur frequently, and/or gradually worsen over time despite treatment. Easy bruising and bleeding is also a potential symptom of leukemia.

 

Should your child’s pediatrician believe that leukemia may be the source of your child’s symptoms, he or she will recommend a blood test, which can indicate the potential presence of leukemia cells in the blood. The blood test will determine how many cells of each type (red blood cells, white blood cells, and platelets) are present in your child’s blood. An abnormally high level of white blood cells and a corresponding low level of red blood cells and platelets may indicate leukemia. A technician will also examine the blood sample under a microscope to look for abnormalities in the blood cells themselves.

 

Should this blood test indicate the potential presence of leukemia in your child’s blood stream, your child will be referred to an oncologist for full diagnostic testing. The first step in a leukemia diagnosis is a bone marrow aspiration and biopsy. This test is done to determine if leukemia cells are present in the bone marrow itself. Usually performed together, a bone marrow aspiration involves removing a small amount of bone marrow through a syringe inserted through the bone via a thin, hollow needle. Then, using a slightly larger needle, a small piece of the bone together with some marrow is removed. The biopsy involves examining the bone and the marrow samples under a microscope to detect the presence of leukemia cells.

 

If your child is diagnosed with leukemia, his or her oncology team will begin a series of additional tests and scans in order to classify and stage the leukemia. These tests will help the oncologists determine the appropriate method of treatment. These additional tests may include:

 

  • Lumbar puncture (otherwise known as a spinal tap) in order to determine if there are leukemia cells in the cerebrospinal fluid
  • Chest x-ray: to detect the potential for an enlarged thymus or lymph nodes, as well as to determine if there is any pneumonia and/or lung infection
  • CT scan or MRI: to detect the presence of leukemia in other organs such as the lymph nodes, spleen, liver, brain, and/or spinal cord
  • PET scan: may be helpful in determining the extent to which leukemia cells have spread throughout the body

 

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 ACCO, or to order resources for you or your child, please visit our website at www.acco.org.

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

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.

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 www.acco.org , call 855.858.2226 or visit:

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 leukemiaJuvenile 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.

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 www.acco.org , call 855.858.2226 or visit: