Treatments for acute lymphocytic leukemia in kids have improved survival rates dramatically; ALL is now very responsive to chemotherapy; 80 percent of children with ALL go into complete remission, the Merck Manual claims, and 85 percent survive five years or more.
Who Gets Acute Lymphocytic Leukemia? Statistics About ALL in Children
ALL is a leukemia occurring mostly in children under age four, although older children and adults can also be affected; Caucasian boys are most likely to develop ALL. ALL accounts for 23 percent of cancers in those under age 15, the National Cancer Institute states. Around 1 in 29,000 children develop ALL. Children between ages three and seven do best; those under two do less well.
Causes of Acute Lymphocytic Leukemia in Children
ALL is a disease of the lymphocytes, white blood cells that fight off infection; immature lymphocytes start rapidly multiplying, crowding out the normal reproduction of normal blood cells such as red blood cells, platelets and mature white blood cells that fight infection. The abnormal cells are carried through the bloodstream to major organs and the brain, where they multiply.
The causes of ALL are unknown, but the disease is more common in those with Down Syndrome and who were exposed to radiation prenatally.
Symptoms and Diagnosis of Acute Lymphocytic Leukemia in Children
ALL starts suddenly, often after a four to six week illness characterized by bone pain, joint swelling, and easy bruisability. Symptoms of ALL include fatigue and pallor from anemia, a decrease in red blood cells, and excessive bleeding and bruising from a decrease in platelets. Bone and joint pain are caused by excess lymphocytes in the bone marrow; if leukemia affects the brain, headaches, irritability and vomiting may occur.
ALL is diagnosed by blood tests or bone marrow testing. The number of total white cells may be normal, or may be low or high, but red blood cells and platelets are decreased. A large number of immature white blood cells will be found.
Chemotherapy Treatments for Kids With Acute Lymphocytic Leukemia
Chemotherapy treatment is very effective and starts with an induction phase, where the fast growing cancer cells are destroyed over several weeks. The consolidation phase of chemotherapy may last as long as several years. Chemotherapy drugs may be injected into the fluid around the brain, followed by radiation, because the cancer cells so often spread to the brain.
If relapse occurs, stem cell transplant may offer the best chance for a cure, but has serious risks and side effects that can be fatal. Siblings or other family members or donors with compatible tissue, or HLA match, can be used.
The Future of ALL; Research into Treatment for Acute Lymphocytic Leukemia
There are many subtypes of ALL; studies are being done to identify genes that cause types of ALL that are more difficult to treat. One such subtype, identified by a gene modification, affects infants and is rarely curable. Research in this field has already improved survival rates tremendously; more improvements in treatment and survivability will undoubtedly continue.