Leukemia in the Pediatric Population

Leukemia is a type of malignant disease that causes the bone marrow and other blood-forming organs to develop an excess of immature or dysfunctional leukocytes. This inhibits the development of healthy blood cells, thus resulting in anemia (caused by abnormal or lack of red blood cells in the body, leading to decreased oxygen flow to the body's organs) and other side effects. These cancers are typically ones that begin in cells that would naturally grow into other various blood cell types. They usually begin in the early stages of white blood cells, but may also begin in other types of blood cells. This deadly form of cancer is unfortunately one of the most prevalent types of cancers developed in the pediatric populations. It is also important to note that there are various types of leukemia depending on different criteria such as origin points of the cancer and development time of the cancer.

For most children who have developed a type of leukemia, the cancer is most likely to be acute. Acute leukemias, contrary to their name, are not “small”; they are the fast progressing types of leukemias. Children who have acute leukemias need to be treated as soon as possible. The main types of acute leukemia in children are acute lymphocytic (lymphoblastic) leukemia (ALL) and acute myeloid leukemia (AML). Both of these leukemias are fast progressing, however one starts in white blood cells, while the other starts from the myeloid cell.

ALL is the type of cancer which begins in the early forms of lymphocytes, or white blood cells. About 3 out of 4 children diagnosed with leukemia have the ALL form of it. On the other hand, AML is the type of acute leukemia which begins from the myeloid cells that normally form white blood (excluding lymphocytes) cells, red blood cells or platelets. AML is also referred to as acute myelocytic leukemia, myelogenous leukemia, or acute non-lymphocytic leukemia and makes up for most of the remaining cases of childhood leukemia. While most children fall into either the categories of ALL or AML when diagnosed with an acute form of leukemia, some children exhibit features of both ALL and AML. These types of leukemias are referred to as mixed lineage leukemias, mixed phenotype acute leukemias (MPALs), or acute undifferentiated leukemias. For children with this type of acute leukemia, they are usually treated like and respond to treatments like ALL.

Chronic leukemias, on the other hand, are rarer in children but still possible. These types of leukemias grow slower than acute leukemias, however they are more difficult to cure. These types of leukemias can be divided into two main types: chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL).In CML, a genetic alteration occurs in an early stage of myeloid cells, resulting in the formation of an irregular gene known as BCR-ABL. The cell is transformed into a CML cell as a result of this mutation. The leukemia cells eventually expand and divide, accumulating in the bone marrow and spilling into the bloodstream. Cells can migrate and settle in different areas of the body over time.Over time, the cells can migrate and settle in other parts of the body. CML is classified as a slow growing leukemia, but it can change into a fast-growing acute leukemia that's even more difficult to treat. The second type of chronic leukemia is CLL, as mentioned beforehand. This type of leukemia starts in cells that eventually turn into lymphocytes within the bone marrow. Over time, this cancer spills over from the bone marrow to the blood and can spread to many parts of the body.

The final, and rarest type of leukemia in children, is juvenile myelomonocytic leukemia (JMML). This rare type of leukemia can neither be classified as chronic or acute. Starting in the myeloid cells of a patient, it does not progress as slow as CML or as fast as AML. This type of leukemia generally occurs in the pediatric population of younger children, around the age of two. Some of the most common symptoms include pale skin, easy bruising, easy bleeding, rashes, fevers and excessive coughing and trouble breathing.

Childhood leukemia is a draining disease for both the child and their family. While there is not a widely recommended screening test for early detection of leukemia in the pediatric population, children who have certain risk factors should have regular checkups. Some of these risk factors include genetic risk factors, lifestyle related risk factors of environmental risk factors.

While most leukemias do not have a definite link to genetic causes, conditions such as Down’s syndrome or Li-Fraumeni syndrome may increase a child’s probability of developing leukemia. Other genetic risk factors include inherited immune system problems or having a sibling that developed leukemia. Lifestyle factors such as excessive drinking, smoking and weight may play a higher role in adult cancers, but not for children. However, a few studies have found that a mother drinking during her pregnancy may increase the leukemia risk for her child. Finally, a few environmental risk factors such as exposure to high levels of radiation, exposure to chemotherapy and other chemicals or immune system suppression may also provide an increased risk for leukemia development in children.

Taking into account how draining this disease is both mentally and physically on both patients in their family, many may feel like they would like to help these people that are struggling through a difficult time in their lives. Using this information and by doing their own research, there are many ways that once can make a difference in the lives of these patients. One of these ways could be to promote or donate to organizations such as Aid2Day, which support cancer and cancer patients through monetary donations to support treatments for patients or by bringing some happiness to the lives of patients. If you really have a passion to support children and adults who have developed this deadly disease, you can even start your own non-profit to help patients who have cancer. Other options include volunteering at a hospital, participating in relays to help fundraise, or partaking in programs to meet cancer patients one and one and spend time with them.

Resources:

https://www.cancer.org/cancer/leukemia-in-children/causes-risks-prevention/risk-factors.html

https://www.cancer.org/involved/volunteer.html

https://www.webmd.com/cancer/lymphoma/childhood-leukemia-symptoms-treatments