About leukemia in children

Leukemia is a blood cancer of white blood cells. It occurs when the cells grow too fast and fill up your bone marrow (the soft, spongy center found in certain bones). These leukemia cells crowd out the good blood cells, meaning there are fewer healthy white blood cells to fight infections.

There are three main types of leukemia in children:

• Acute lymphoblastic leukemia (ALL)
• Acute myelogenous leukemia (AML)
• Chronic myelogenous leukemia (CML)

Leukemia is the most common childhood cancer, affecting approximately 4,000 children in the U.S.

Causes of leukemia

The exact cause of leukemia in children is not known.

Most of the time leukemia is not genetic (inherited). This means it does not come from your parents. Having a brother or sister with leukemia can very rarely increase your risk of having leukemia.

However, there are certain genetic and immune system conditions passed on from parents to children that increase the risk for childhood leukemia. Examples are Down syndrome and Bloom syndrome.

Signs of leukemia

Leukemia can be in the bone marrow, blood or other tissues and organs.

Symptoms depend on many factors. and can include:

• Headaches
• Pale skin
• Feeling tired, weak or cold
• Dizziness
• Belly (abdominal) swelling
• Shortness of breath, trouble breathing
• Frequent infections or infections that don't go away
• Small, flat, red spots under the skin
• Fever
• Easy bruising or bleeding such as nosebleeds or bleeding gums
• Bone or joint pain
• Not eating
• Weight loss
• Swollen lymph glands (nodes) in the neck, armpits or groin

How is leukemia diagnosed?

Diagnosing leukemia begins with a medical examination by our providers. Diagnostic procedures may include one or more of the following:

• Bone marrow biopsy or aspiration: This procedure involves taking a small amount of bone marrow fluid and/or solid bone marrow tissue to examine the blood cells for abnormalities.
• Blood count (CBC): A complete blood count (CPC) measures the size, number and maturity of different blood cells.
• CT scan, ultrasound MRI and/or X-ray: Using diagnostic procedures like these, we can get a detailed picture of the body, from organs to blood vessels.
• Lymph node biopsy: A sample of tissue is removed from the lymph node and examined under a microscope.
• Spinal tap/lumbar puncture: A special hollow needle is placed into the spinal canal in the lower back. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured.

How is leukemia treated?

Treatment may include:

• Chemotherapy
• Radiation therapy
• Bone marrow transplantation (stem cell transplant)
• Medications (to prevent or treat damage to other systems of the body caused by leukemia treatment or for the side effects of the treatment)
• Blood transfusions (red blood cells, platelets)
• Continuous follow-up care with our support team
• Targeted therapy
• Immunotherapy
• Clinical trials. Ask our providers if there are any treatments being tested that may work well for your child. Learn more about clinical trials.

Supportive care for children with leukemia

Our supportive care treats the whole child, not just the disease. Supportive care includes medicines and other treatments used to manage side effects such as pain, fever, infection, nausea and vomiting.

Our comprehensive team provides care to support the unique needs of each patient and family. Members of the team include:

• Child life
• Art and music therapy
• Education support
• Social work
• Dedicated psychology for hematology and oncology patients
• Nutrition services
• Care navigation
• Expert pharmacy services through pharmacists our on-site chemo and retail pharmacies. Clinical pharmacy specialists in pediatric hematology and oncology work alongside the medical team to help guide therapies and supportive care plans. Clinical pharmacists prioritize safety and optimize therapy plans by ensuring medications are dosed and adjusted to maximize your child's medication plan and reduce any unwanted side effects.

What is the outlook for children with leukemia?

As with other cancers, the outlook can vary from child to child.

The key to increasing positive outcomes is early detection. If you suspect your child might have leukemia, schedule an appointment to be seen by our nationally ranked cancer specialists.

Learn more about our nationally ranked cancer care