Acute Lymphoblastic Leukemia (Paediatric Hemato Oncology)

Acute Lymphoblastic Leukemia

What is Acute Lymphoblastic Leukemia?

Leukemia is a cancer of the bone marrow, the substance inside of bones that makes blood cells. Because it primarily affects the blood, leukemia is typically called a blood cancer

Leukemia affects lymphocytes, or white blood cells, a part of the immune system that helps fight infection. In leukemia, the bone marrow produces a lot of abnormal white blood cells that don’t function the way they should.

The buildup of abnormal blood cells in childhood leukemia can impact the body in a lot of different ways. Too many abnormal white blood cells can crowd out normal, healthy red blood cells and platelets, which prevents the healthy cells from doing their jobs.

For example, red blood cells carry oxygen to all parts of the body. A lack of red blood cells is called anemia, which can make people very tired and can make the heart work too hard. Platelets help the blood clot, which stops bleeding. A low number of platelets usually means people bruise more easily and severely.

The job of white blood cells is to fight infection by attacking infectious agents. The abnormal white blood cells of leukemia will sometimes attack healthy parts of the body.

Leukemia symptoms may include:

  • Bruising
  • Bleeding
  • Fatigue
  • Fever
  • Bone pain
  • Infections

Symptoms like these do not always indicate leukemia. If they last a couple of weeks or more, however, a doctor can perform tests to determine the cause.

Every child is unique, so every case of childhood leukemia will have differences. By and large, though, nearly all cases of childhood leukemia are acute, meaning fast-growing (as opposed to chronic leukemias, which are slow-growing), and fall into one of two basic categories:

  • Acute lymphoblastic leukemia (ALL): White blood cells go through several different phases as they mature. Acute lymphoblastic leukemia starts early in the white blood cell life cycle, when they are called lymphocytes. Cancerous lymphocytes are called lymphoblasts. About 75% of childhood leukemia patients have some form of ALL, which is most often treatable and curable, usually with well-established medicines such as chemotherapy. The overall survival rate for ALL is very good, approaching 90%, although it varies somewhat depending on the type of leukemia and the risk factors involved.
  • Acute myeloid leukemia: Normally found in the bone marrow, healthy myeloid cells mature to become different types of white blood cells. In children with AML, cancerous myeloid cells, also called myeloblasts, reproduce too quickly and circulate in the blood. AML accounts for about 20% of all childhood leukemias. AML is also treated with chemotherapy, sometimes requiring a bone marrow transplant as well.

Some children do get a type of leukemia called chronic myelogenous leukemia as well, but it’s very rare, accounting only for about 1% of cases. Acute leukemias are most common in children, whereas chronic leukemias are more common in adults.

Leukemia is the result of the rapid buildup of abnormal white blood cells. It’s not known exactly what causes leukemia in children, although it is most likely related to changes in the genes within blood cells, possibly as the result of a viral infection or other factors. These changes are not usually inherited from parents; in other words, having one child with leukemia does not typically mean siblings or other family members are at risk.

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