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Leukemia is a type of cancer. It develops in the bone marrow. This is where blood cells are made. The leukemia cells do not function normally. They cannot do what normal blood cells do. For example, white blood cells fight infections. If the cells do not grow properly because of cancer, then the body cannot protect itself from infections. Leukemia can also affect red blood cells and platelets.

There are different types of leukemia, but the two types that are most common in children are:

• Acute lymphocytic leukemia (ALL)—This affects cells called lymphocytes. These are part of the immune system. With ALL, too many lymphocytes are produced. Other blood cells cannot get nutrients to grow properly. The body is not able to fight infection.
• Acute myeloid leukemia (AML)—This affects cells that normally develop into other cells. Since the cells are not able to function properly, the body is more vulnerable to infection.

White Blood Cells

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With this type of cancer, genetic material is not working properly in the bone marrow cells. This affects how the cells develop and function.

Risk factors include:

• Environmental and chemical factors—exposure to the chemical benzene (used in the cleaning and manufacturing industries), some chemotherapy drugs, or high doses of radiation
• Genetic factors
  • Having a sibling, especially an identical twin, who develops leukemia
  • Having a genetic condition, such as Down syndrome , Li-Fraumeni syndrome, Klinefelter syndrome , Wiskott-Aldrich syndrome, ataxia-telangiectasia, neurofibromatosis , Fanconi anemia

Common symptoms include:

• Anemia —This happens because there are not enough red blood cells and can cause:
  • Weakness and fatigue
  • Pale skin
  • Shortness of breath
  • Decreased energy
• Bleeding or bruising—This happens because there are not enough platelets. Tiny red spots, called petechiae, may also appear.
• Recurrent infections—The white blood cells are not able to fight infection. The child may have a fever, chills, and a cough .
• Bone and joint pain
• Abdominal pain
• Weight loss, loss of appetite
• Swollen lymph nodes, swelling of the liver or spleen
• Difficulty breathing
• Rash, gum problems

These symptoms may be due to other conditions. If your child has any of these, talk to the doctor.

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor will check for swelling of the liver, spleen, and lymph nodes. Tests may include:

• Blood tests—to check for abnormal blood cells
• Bone marrow biopsy and aspiration—removal of liquid bone marrow and a small piece of bone to test for cancer cells
• Lumbar puncture (spinal tap)—removal of a small amount of fluid that surrounds the brain and spinal cord to test for cancer cells
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
• X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
• Ultrasound—a test that uses sound waves to examine the body
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the body

Talk with the doctor about the best treatment plan for your child. Some of the treatment options include:

• Chemotherapy—There are a number of different chemotherapy drugs that are used to treat leukemia.
• External beam radiation—A type of radiation therapy targets a certain part of the body.
• Blood transfusions
• Bone marrow transplantation —Cancerous bone marrow is destroyed and then replaced with healthy bone marrow.
• Biological therapy—This involves using medicine or substances made by the body to increase or restore the body’s natural defenses against cancer.
• Antibiotics to prevent infections
• Medicines for side effects (eg, nausea and vomiting from chemotherapy)
• Lifestyle changes—For example, your child will need to avoid being exposed to bacteria and viruses.

There is no known way to prevent childhood leukemia. You may be able to reduce your child’s risk of leukemia by having him avoid certain environmental factors.