Leukemia is the most common type of cancer in children and teens, accounting for almost one-third of all cancers. Acute lymphocytic leukemia, ALL, is the most common type of childhood leukemia, and acute myeloid leukemia, AML, makes up most of the remaining cases. Children rarely have chronic leukemia. In this blog, we will review childhood leukemia and its common causes.
Leukemia can be either short-term or long-term. Acute leukemias are more aggressive and involve blood cells that aren’t fully grown yet. Chronic leukemias, on the other hand, tend to grow more slowly and involve blood cells that are fully grown. Leukemia is further divided into four main types based on the types of cells that are affected.
- Acute lymphocytic leukemia (ALL)
- Acute myelogenous leukemia (AML)
- Chronic lymphocytic leukemia (CLL) (CLL)
- Chronic myelogenous leukemia (CML)
What are the Symptoms of Leukemia in Children?
Different things can cause the symptoms. Cancer can be in the bone marrow, the blood, and other tissues and organs, which includes the lymph nodes, liver, spleen, thymus, skin, gums, and spinal cord. Every child’s symptoms can be a little bit different, and some of these include:
- Pale skin
- Feeling cold, tired, or weak
- Trouble breathing or getting enough air
- Infections that happen often or last a long time
- Bruising or bleeding easily, such as from the nose or gums
- Bone or joint pain
- Swelling of the stomach
- Poor appetite
- Weight loss
- Swollen lymph nodes
What Causes Childhood Leukemia?
Most childhood leukemias don’t have a clear cause. Most children with leukemia do not have any known risk factors. However, some changes in the DNA of normal bone marrow cells can cause them to grow out of control and turn into leukemia cells. DNA is the chemical in our cells that makes up our genes, which control how our cells work. We often look like our parents because our DNA comes from them. But genes affect more than just how we look.
Some genes control when our cells grow, divide into new cells, and die:
- Oncogenes are genes that help cells grow, divide, or stay alive
- Tumor suppressor genes stop cells from dividing too much or make sure that cells die at the right time
Cancers can be caused by DNA mutations or other changes that keep oncogenes turned on or turn off genes that stop tumors from growing. These gene changes can be passed down from a parent, which is sometimes true with childhood leukemias, or they can happen randomly during a person’s lifetime if cells in the body make mistakes when they divide to make new cells.
A chromosome translocation is a common change to DNA that can cause leukemia. 23 pairs of chromosomes hold all of a person’s DNA. In translocation, a piece of DNA from one chromosome breaks off and joins with DNA from another chromosome. Where the break is on the chromosome can affect oncogenes or genes that stop tumors from growing. For example, a swap of DNA between chromosomes 9 and 22 is a translocation that is seen in almost all cases of childhood chronic myeloid leukemia (CML) and some cases of childhood acute lymphocytic leukemia (ALL). This swap leads to what is called the Philadelphia chromosome. This makes BCR-ABL, which is an oncogene that helps leukemia cells grow. In childhood leukemias, scientists have also found many other changes in chromosomes or specific genes.
Can Leukemia be Cured?
At this time, there is no cure for leukemia, and cancer can still come back. However, patients can go into remission, which is when there are no longer any signs or symptoms of cancer. Patients with leukemia now have access to several advanced treatments that can help them go into remission without it coming back including:
- Treatment with x-rays
- Transplants of bone marrow
- Therapy with monoclonal antibodies
- Clinical trials
What Treatment Options are there for Leukemia?
Treatment for leukemia will depend on many things. Your doctor decides how to treat your leukemia based on your age, overall health, the type of leukemia you have, and whether or not it has spread to other parts of your body, including your central nervous system. Some of the most common ways to treat leukemia are:
- Chemotherapy – The main way to treat leukemia is with chemotherapy. Chemicals in this drug are used to kill leukemia cells. Depending on the type of leukemia you have, you may get one drug or a combination of drugs and these drugs can be taken as pills or injected straight into a vein
- Targeted therapy – Targeted drug treatments are based on the fact that cancer cells have certain abnormalities, and by stopping these from happening, targeted drug treatments can kill cancer cells.
- Radiation therapy – X-rays or other high-energy beams are used in radiation therapy to damage leukemia cells and stop them from growing. During radiation therapy, you lie on a table while a big machine moves around you and sends radiation to specific parts of your body.
- Bone marrow transplant – A bone marrow transplant, which is also called a stem cell transplant, helps restore healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will grow healthy bone marrow. Before a bone marrow transplant, you get very high doses of chemotherapy or radiation therapy to kill the bone marrow cells that cause leukemia. Then you get an infusion of blood-making stem cells that help rebuild your bone marrow
- Immunotherapy – Immunotherapy is a way to fight cancer by using your immune system. Your immune system, which fights diseases, might not be able to attack your cancer because the cancer cells make proteins that help them hide from immune system cells. Immunotherapy works by stopping this from happening.
- Engineering immune cells to fight leukemia – Chimeric antigen receptor (CAR)-T cell therapy is a type of treatment that takes your body’s T cells that fight germs, changes them so they can fight cancer, and then puts them back into your body. For some types of leukemia, CAR-T cell therapy might be a choice
- Clinical trials – Clinical trials are experiments that test new ways to treat cancer and new ways to use treatments that have already been proven to work. You or your child may be able to try the latest cancer treatment through a clinical trial. However, the benefits and risks of the treatment may not be clear, making it important to speak with your doctor about the pros and cons of clinical trials.
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