Half a century ago, childhood leukemia was essentially incurable, but significant investment into leukemia research during the intervening years has had a tremendous impact on treatment outcomes. For example, the cure rate at modern treatment centers for standard and low-risk forms of acute lymphoblastic leukemia (ALL) is now between 65 and 90 percent. Significant gains in the treatment outcomes for children suffering from high-risk forms of ALL and acute myeloid leukemia (AML) have also been realized. Since approximately 80 percent of all cases of childhood leukemia’s are ALL, these improvements have had large impact on this field and the outlook for affected families. Most of the other children suffering from childhood leukemia, between 15 and 20 percent, suffer from AML.

Causes of Acute Lymphoblastic Leukemia

The causes of acute lymphoblastic leukemia are still unknown, but research has been providing some hints. One theory is that during fetal development the DNA in the blood cells acquire large mistakes and as the infant grows older these mistakes amplify and leukemia develops. Children who suffer from other diseases caused by DNA abnormalities, such as Down Syndrome, are also more likely to develop leukemia. Other studies have revealed that children of parents who have had ALL are more likely to develop it, which suggests that for some children the risk of developing this disease is inherited. Another predisposing factor for the development of childhood leukemia is viral infection, including human immunodeficiency virus (HIV), influenza, and chickenpox.

Getting Help

The first step is always to have a child examined by the family pediatrician, such as a physician specializing in pediatric hematology/oncology in Norfolk, for example. The symptoms that should trigger a visit include any of the following:

• Bleeding gums

• Fever

• Frequent infections

• Frequent or severe nosebleeds

• Swollen lymph nodes around the neck, stomach, groin, or under the arms

• Pallor

• Difficulty breathing

• Weakness or fatigue

Treatment Approaches

Treating ALL involves three distinct phases called induction, intensified consolidation, and maintenance. Induction involves chemotherapy and steroid drug treatment and typically produces remission in 72 to 92 percent of patients. Consolidation involves a modified form of induction that may incorporate subtype and risk-oriented treatments, including stem cell transplantation. Additional chemotherapy steps will likely be added during consolidation to reduce the possibility that the child’s brain will be invaded by diseased cells, because studies have shown that without these additional steps brain cancer will form in 50 to 75 percent of patients within a year following diagnosis of certain types of leukemia. Maintenance involves an additional 2 to 3 years of chemotherapy to prevent relapse.