Leukaemia In Children

Learning About Leukaemia In Children

Gone are the days when cancer diagnosis was an inevitable death sentence. Many malignant conditions can now be treated, controlled and often cured. This is especially true with childhood cancers.

Fortunately, cancer ¡s rare in children when compared to older people.

Children with cancer also respond much better to treatment, unlike many of their adult counterparts. Leukaemia accounts for one-third of all childhood cancers. Of the different types of leukaemia patients, 75 per cent have acute lymphoblastic leukaemia (ALL) and 20 per cent have acute myeloid leukaemia (AML). The remaining five per cent is constituted by other rare types of paediatric leukaemia,

ALL, is thus the most common type of paediatric cancer. Treatment of ALL represents one of the major success stories in hemato-oncology. With current chemotherapy protocols, over 80 per cent children with ALL get completely cured. AML, the less common type of leukaemia. s more aggressive and often resistant to chemotherapy. With modern day protocol-based treatment and good quality supportive care, a fair proportion of children with AML too are now cured completely.

What Is Leukaemia?

In simple terms, leukaemia is blood cancer. It starts in the early (immature) blood-forming cells found in the bone marrow, the soft inner part of bones. Leukaemia occurs when the bone marrow elements destined to become white blood cells undergo a malignant change. Once this change takes place, the leukaemia cells no longer mature in a normal way. Leukaemia cells reproduce quickly and do not die when they should. They build up in the bone marrow like weeds, stopping the production of normal blood cells.

Leukaemia is blood cancer and starts in the early (immature) blood-forming cells found in the bone marrow. It occurs when the bone marrow elements destined to become white blood cells undergo a malignant change

Causes And Symptoms

Children with specific genetic disorders (such as Downs syndrome, neurofibromatosis and chromosomal breakage disorders) and those with a strong family history of multiple cancers are at a higher risk of getting leukaemia compared to other kids. Other identified causes include ionizing radiation, carcinogenic drugs and chemicals and certain rare viral infections.

However, all these causes together account for only 10 per cent of all childhood cancers. Thus the vast majority of cancers occur in otherwise healthy children, with no obvious identifiable cause. Contrary to popular belief, it is not related to diet, lifestyle, infections or climatic changes.

Blood cancer in children presents symptoms such as paleness, tiredness, shortness of breath, bruises, bleeding from nose, mouth or bowel, bone pain, lymph gland swelling and increased susceptibility to infections. A few children may have recurrent fever or weight loss. And some kids may look healthy but when detected they may have an abnormal blood count.

Evolution Of Treatment

In some of the treatment centres in the Western world, over 90 per cent of ALL and approximately 60 per cent of AML in children are now completely cured. This is in contrast to a survival rate of less than 10 per cent in the late 1960s. A similar but less impressive trend is noticeable in India and the rest of the developing nations. Despite accessibility to almost all the diagnostic tests, chemotherapy medications and radiation facilities available in the West, the survival of childhood cancers in developing countries is significantly inferior.

The cause for this wide gap is multifactorial, including higher incidence of deaths due to infections. poor nutritional status of children, late detection of disease, cost of treatment and lack of sufficient number of trained medical staff. The gap s slowly getting bridged and the outcome of childhood cancers in some of the dedicated tertiary treatment centres in India are now comparable to that of developed countries.

What The Treatment Involves

If your child has any of the earlier mentioned symptoms. an urgent consultation with a family physician or paediatrician is warranted. A simple complete blood count (CBC) and microscopic examination of the blood film are very helpful in evaluating suspected cases of blood cancer. Once the diagnosis of leukaemia is made, it is important to remain optimistic and have faith in your paediatric hemato-oncologist.

Often chemotherapy may continue for many months or sometimes even up to three years, especially for boys with ALL. With good treatment, leukaemia is usually cleared from the bone marrow and blood within a month of starting chemotherapy.

Despite this, it is important to complete the full treatment course so that the disease does not recur. With increased parental awareness and availability of adequately trained specialists, the survival of children with cancer in India should improve steadily.