Leukemia is derived from the Greek words leukos meaning white, and haima meaning blood. It is a type of cancer of the blood and/or bone marrow (blood generating organ within the long bones) and is characterized by an abnormal increase of white blood cells (TLC). Leukemia is a broad term covering a spectrum of diseases. It is part of the even broader group of diseases affecting the blood, bone marrow and lymphoid system, which are all known as hematological neoplasms.
Types Of Leukemia
Acute lymphoblastic leukemia (ALL):
- It is the most common type of leukemia affecting young children.
- Children can present at any age from newborns to adolescent.
- Children between 2-6 years of age fare better in terms of final outcome.
- Females fare better than males in prognosis.
- The Etiology of leukemia is multifactorial:- Genetics, Infections, Environmental causes.
- Investigations: Various Blood tests need to be done for making the diagnosis.
- Standard treatments involve chemotherapy and radiotherapy.
- The survival rates vary by age:
Minimum Risk Group survival rate is 80%.
In High Risk cancer Group survival rate is 50%.
Symptoms (Noticed by the parents/ teachers)
- Night Sweats
- Weight Loss
- Refusal to play
Sign (Noted by Physician)
- Bone pains(Pain in legs/arms)
- Lymphadenopthy(Swellings in neck,axilla,groin)
- Hepatpmegaly(Increased liver size)
- Splenomegaly(Increase in the size of spleen)
- Petechiae(Small round red spots on the skin anywhere on the body due to intradermal bleed)
- Gum Hypertrophy(enlarged gums)
- Bleeding gums
- Intra-oral hematomas(Bleeding in the mucosa of the mouth)
Diagnosis is based on the clinical findings and various blood tests needed to categorize the type of cancer and the prognosos;whether good or bad.
Investigation that need to be done and/or repeated are:
Treatment of leukemia is based on chemotherapy i.e. use of drugs given via oral, intravenous, subcutaneous and intra-thecal (into the back) route to avoid leukemia spreading to the brain and to other organ of the body and/or treat it if it has already spread.
Treatment is usually given over a period of 2 years in ALL and around 6 months in AML. Some patients may require bone marrow transplant for complete cure.
Complications of the chemotherapy
There are various side effects of treatment as chemotherapy is strong medication. The child can have:
- Decreased appetite
- Hair fall
- Oral ulcers
- There is constant need for blood transfusions and platelet transfusions as the chemotherapy is eradicating the disease process form the body the bone marrow stops producing these cells and have to be replaced.
Special Instructions to the parents
- Measure fever twice a day with a clean thermometer and report to hospital immediately if fever is more than or equal to 100f
- Report to hospital in case of fever, vomiting, bleeding, or anything unusual in the child’s daily activity.
- No vaccinations should be administered during the chemotherapy
- No uncooked food items to the given to the child like salads, fruits.
- Use boiled (cooled) and/or filtered water only.
- Maintain personal and dental hygiene.Brush teeth with finger.
- Child should not be isolated but avoid contact with sick family members and friends.
- Toys should be cleaned regularly and stuffed toys should be avoided.