Pediatric Leukemias | Miami Cancer Institute | Baptist Health South Florida
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 Pediatric Leukemias

Leukemia is the most common form of cancer in children, affecting approximately 4,000 youngsters each year in the U.S. and accounting for about one in three childhood cancers.

When a child has leukemia, the bone marrow – the soft, spongy center of certain bones – begins to make new blood cells (usually white blood cells) that do not mature correctly, but continue to reproduce themselves. Normal white blood cells help fight off infection, but these abnormal cells cannot. When the immature white blood cells, called blasts, begin to crowd out other healthy cells in the bone marrow, the child experiences the symptoms of leukemia (such as infections, anemia or bleeding).

What causes leukemia?

Most childhood leukemias occur by chance and are not inherited from a parent. However, having a brother or sister with leukemia carries a slight risk. Also, children with inherited immune system problems and children who have chemotherapy to treat some other types of cancer have an increased risk of developing leukemia. Some genetic conditions, such as Down syndrome or Li-Fraumeni syndrome, carry a higher risk, as well.

There are a number of types of pediatric leukemia. The type of leukemia is determined by the kind of blood cell that is affected and the stage of development when the normal cells become leukemia cells.

The three most common types of pediatric leukemia are:

  • Acute lymphocytic leukemia (ALL). Also called lymphoblastic or lymphoid, it accounts for most of the childhood leukemias. With ALL, the bone marrow makes too many lymphocytes, crowding out other blood cells. The immature cells do not work properly to fight infection. ALL can occur over a short period of days to weeks.
  • Acute myelogenous leukemia (AML). You may also hear this referred to as granulocytic, myelocytic, myeloblastic or myeloid. It accounts for most other childhood leukemias. There are different types of AML, but this is usually a cancer of the blood in which too many granulocytes, a type of white blood cell, are produced in the marrow. Granulocytes normally fight infection. AML can occur over a short period of days to weeks.
  • Chronic myelogenous leukemia (CML). This form of cancer is less common in children and occurs, like AML, when too many granulocytes are produced in the marrow. CML is a slow growing form of leukemia and can occur over a period of months or years.

What are the symptoms of leukemia?

The following are the most common symptoms of leukemia and may come on suddenly or take place over a period of weeks. Each child may experience symptoms differently.

  • Easy bleeding and bruising
  • Frequent nosebleeds
  • Anemia, often causing a child to become pale, tired and have rapid breathing
  • Recurrent infections, which occurs when immature white blood cells do not fight infection. The child with leukemia often shows symptoms of an infection, such as fever, runny nose and cough, and can have repeated infections in a month.
  • Bone and joint pain
  • Fatigue and weakness
  • Abdominal pain distress, sometimes with loss of appetite and weight loss
  • Swollen lymph nodes
  • Shortness of breath, coughing or wheezing

There is a wide range of treatment options for children with leukemia, and the tests involved in diagnosing the disease help doctors better analyze your child’s condition ― and help determine the best treatment. Your child’s doctor generally will complete a thorough medical history and may order a number of tests. Because there is no single way to treat cancer, your child’s testing and care plan may be very different from another child’s, even if they have the same type of cancer.

The most common tests for leukemia are:

  • Bone marrow aspiration and/or biopsy
  • Complete blood count and other blood tests
  • Imaging studies, including MRI, X-ray, CT and ultrasound
  • Lymph node biopsy
  • Spinal tap/lumbar puncture to look for leukemia cells in the cerebrospinal fluid

At Miami Cancer Institute, the comprehensive treatment of your child involves numerous specialists. You may see several pediatric physicians, oncologists, surgeons and radiation experts, as well as nurses, dietitians, therapists and social workers. We understand that this can be a confusing and stressful time for every family member, and we are here to help.

Treatment may include any of the following, alone or in combination:

  • Chemotherapy
  • Medications to prevent or treat leukemia in other parts of the body, including the spinal cord and brain, or targeted therapy using drugs that attack specific cell
  • Radiation therapy​
  • Bone marrow (stem cell) transplants
  • Blood transfusions
  • Antibiotics to prevent or treat infections
  • Occasionally, surgery

Stages of leukemia treatment

Generally, the treatment of acute leukemia proceeds through the following stages:

  • Induction. With the goal of remission, a combination of chemotherapy is given to stop the process of abnormal cells being made in the bone marrow. Remission means the leukemia cells can no longer be detected. More than 95 percent of children with ALL enter remission after one month of induction.
  • Intensification (consolidation). Chemotherapy is continued for a couple of months even though leukemia cells may not be visible. For some children with high-risk leukemia, the doctor may recommend high-dose chemotherapy with a stem cell transplant at this time.
  • Maintenance. Less intense chemotherapy is given for a longer duration to maintain leukemia-free bone marrow. This is used for ALL but not for AML and can last for several months or several years. Treatment for CML may begin with a targeted therapy drug.

Every patient and every cancer is different so prognosis and long-term survival can vary greatly from child to child. Long-term follow-up care is important. The healthcare team at Miami Cancer Institute will work closely with you and your family to develop the best treatment plan for your child.​