What are the most common types of Leukaemia in children?
Leukaemia affects people of all ages. Approximately 85% of leukaemias in children are of the acute type which means that they spread more rapidly but there are also more cures for them. Acute lymphocytic leukaemia (ALL) affects both children and adults but is more common in children. It accounts for 65% of the acute leukaemias in children. About 5% of childhood leukaemias are distinct types of chronic myeloid leukaemias. Young myelomonocytic leukaemia JMML occurs mainly in children aged 2 or under. Acute promyelocytic leukaemia APL is a distinct subtype of AML. A rare type of leukaemia in children is Anaplastic Large Cell Lymphoblastic Leukaemia, or ALCL.
The most common type of leukaemia in children is acute lymphocytic leukaemia or ALL. Childhood acute myeloid leukaemia or AML is less common but there are still cases of it. In general, acute leukaemias are most common in children and are therefore often referred to as "childhood leukaemias".
Some of the common symptoms of ALL include:
• Fever
• Fatigue
• Frequent infections
• Swollen or tender lymph nodes, liver, or spleen
• Paleness or pallor
• Easy bleeding or bruising
• Tiny red spots (called petechiae) under the skin
• Bone or joint pain
Cancer in children and adolescents is rare. But, ALL is the most common cancer in children, representing 23 percent of cancer diagnoses among children younger than 15 years of age. It occurs in about one of every 29,000 children in the United States each year.
What is the survival rate for children with ALL?
The improvement in survival for children with ALL over the past 35 years is one of the great success stories of cancer treatment. In the 1960s, less than 5 percent of children with ALL survived for more than five years. Today, about 85 percent of children with ALL live five years or more.
What are the treatments for childhood leukaemia?
ALL: The key treatment for newly diagnosed ALL is combination chemotherapy. Radiation and bone marrow transplantation may be used in some cases. Treatment begins with an intense treatment called "induction". The goal of induction is to kill most of the leukaemia cells; most patients do not have any leukemic cells in the bone marrow at the end of induction. The next phase is called "consolidation”. "Maintenance" follows, in which the chemotherapy is lessened. Maintenance is generally bearable for the patient. Often a period of maintenance is followed by another cycle of induction-consolidation, called "re-intensification". Total therapy lasts from two to three years.
AML: In general, newly diagnosed AML is initially treated more aggressively than ALL. Intensive chemotherapy followed by bone marrow transplantation is becoming the first treatment chosen, especially when a suitable donor is available. After the intensive chemotherapy and/or bone marrow transplant, children with AML do not go on maintenance; studies have shown that AML children in remission have had as much chemotherapy as their bodies can tolerate, and additional maintenance chemotherapy does not benefit them.
Relapsed leukaemia. Relapse, or return of leukaemia, can occur anytime during therapy or after completion of treatment. Generally, it is more difficult to cure a child after relapse of the leukaemia; relapse during or soon after the completion of treatment is considered less beneficial than relapse a year or several years after treatment. Treatment depends on the site of relapse, whether it is in the bone marrow, central nervous system, testes, or other locations. Aggressive chemotherapy and radiation treatment, often followed bone marrow transplantation, are used to treat relapse of childhood leukaemia.
