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Leukaemia in children

www.irishhealth.com]

Leukaemia in children

  • What is leukaemia?
  • Why does leukaemia occur in children?
  • What are the symptoms of leukaemia?
  • How can leukaemia be treated?
  • How is a bone marrow transplant carried out?
  • What is the outlook for leukaemia in children?
  • Where can parents of children with leukaemia get information and support?

What is leukaemia?

Leukaemia is the medical name for cancer of the blood. It is a very serious illness in which the marrow inside the body’s bones produces a large number of abnormal bone marrow cells. The remaining healthy cells have less space in which to develop, which means that less red blood cells and platelets are produced. There are many types of leukaemia, as many as the different types of marrow cell affected.

Leukaemia is classified as either chronic or acute, depending on the type of disease and how long it takes to develop. Chronic leukaemia progresses more slowly. Acute leukaemia attacks immature bone marrow cells and has a much more sudden onset. It is the rarer form of leukaemia, but unfortunately it tends to be the form of leukaemia most common in children.

Leukaemia is also classified according to the particular type of white cell that is proliferating abnormally. The commonest type of leukaemia in childhood is caused by abnormal proliferation of cells derived from lymphocytes or from lymphoblasts and thus the condition is called acute lymphoblastic leukaemia.

The causes of leukaemia are unknown, but the disease seems to afflict more males than females — in Ireland in 1995, 204 males compared to 104 females were diagnosed with leukaemia.

Why does leukaemia occur to children?

The causes of leukaemia are not known, but the seriousness of the disease has led many cancer research specialists to focus their efforts on this area. It is hoped that future genetic research may cast some light on the origins of this disease.

What are the symptoms of leukaemia?

Leukaemia usually requires blood tests to confirm diagnosis, but it does manifest symptoms, very suddenly in the case of acute leukaemia. The things to look out for include:

  • Fatigue
  • Repeated niggling infections, such as chest infections or sore throats
  • Pale skin, due to anaemia
  • Unexplained or easy bruising
  • Bleeding gums
  • Bone tenderness
  • Weight loss
  • Night sweats and fevers
  • Headache
  • Enlarged lymph nodes.

Obviously, many of these symptoms can be found in children who are not suffering from leukaemia. However, if your child exhibits more than one of these symptoms, especially if they appear suddenly, you should consult your GP. It is most likely that your child has a minor illness. If your doctor is concerned, arrangements will be made for blood tests to check for leukaemia.

How can leukaemia be treated?

Leukaemia is a difficult disease to treat, as it involves a disruption of the body’s ability to produce new blood cells. Usually, patients will be referred to a specialist clinic located in one of the major Irish teaching hospitals.

Treatment usually takes the form of chemotherapy, which can be given as pills or an injection. A catheter (tube) is usually inserted into a large vein near the heart under anaesthesia and the anti-cancer drugs are given through it. Each course of chemotherapy lasts a number of days and the side-effects may cause discomfort. Chemotherapy attacks a proportion of healthy bone marrow cells as well as the cancerous ones, and can deplete the patient’s strength and ability to fight infection. Therefore, strong antibiotics may also be given to fight infections.

Your child may have to stay in hospital to recover from chemotherapy treatment, and may receive blood transfusions to make up for blood lost through bleeding. Transfusions can also be given through the catheter described above. Chemotherapy may cause vomiting and nausea, and can lead to hair loss. None of these symptoms are permanent, though it may be a few months before hair will grow back. Baldness caused by chemotherapy can lead to a loss of self-esteem in many children, especially girls. However, you will find that hospital staff are extremely supportive of both you and your child during this difficult time.

Radiotherapy may also be given in many cases.

In certain cases, the leukaemia may warrant a bone marrow transplant.

How is a bone marrow transplant carried out?

The marrow cells used are removed from a donor and replaced in the individual with leukaemia, and must be as close a match as possible.

Occasionally, the cells are those of the child themselves (an autologous transplant), stored in advance by the hospital. Often, the donated cells will come from a close relative or an unrelated donor (an allogeneic transplant). A full sibling (brother or sister) is usually the best match.

Because not everyone has a relative whose bone marrow cells match their own, a bone marrow transplant registry is in place, based at the Irish Blood Transfusion Service headquarters in Dublin. Volunteer donors attend a blood transfusion clinic for tests, and their marrow cell details are stored on a registry until needed or until the would-be donor is 55 years of age. These marrow donations are known as MUD (matched unrelated donor) transplants. If you would like more information on becoming a bone marrow donor, contact :

The National Bone Marrow Registry at:

Pelican House,

40 Mespil Road,

Dublin 4.

Tel: (01) 6603333

Fax: (01) 6603419.

You can also contact them via email at info@ibts.ie.

What is the outlook for leukaemia in children?

While leukaemia is a serious condition, the outlook for acute lymphoblastic leukaemia (the commonest type in children) is better than that for acute myeloblastic leukaemia and it is better for children than for adults.

Where can children with leukaemia get information and support?

If your child is diagnosed with leukaemia, you can be sure that you will receive information and support from the hospital in which you are treated. Chemotherapy treatment is arduous, especially for children, and medical staff are very sympathetic and will help in so far as they can.

The Irish Cancer Society offers information and support to all people with cancer, including leukaemia, and their families. They have a website at www.cancer.ie and run a telephone cancer helpline at 1800 200700. One support group they run is called CanTeen, and is aimed at teenage cancer patients and their families and friends. Parents of children with cancer may be interested in a support group called CancerPlus, which offers help and support to parents.

The Children’s Leukaemia Research Project raises funds for research into leukaemia in children. They publish a quarterly newsletter and occasionally represent parents if requested. The Project can be contacted at:

40 Clancy Avenue,

Finglas,

Dublin 11.

Tel. (01) 8343986.

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Last Reviewed: 9th October 2000



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