Leukaemia in Children: Symptoms and Treatment

What are the types of leukaemia in children?

Leukaemia is a type of cancer that affects the white blood cells and is characterised by the abnormal proliferation (production by multiplication) of white blood cells in the bone marrow.

There are two known types of leukaemia in children:

• Acute lymphoblastic leukaemia (ALL): This is the most common type of childhood leukaemia. It affects lymphocytes, a type of white blood cell and progresses quickly if untreated. However, the prognosis is often favourable with early intervention.
• Acute myeloid leukaemia (AML): AML affects the myeloid cells, which produce various types of blood cells like red blood cells, white blood cells, and platelets. It also progresses rapidly and requires prompt treatment.

What are the risk factors for childhood leukaemia?

The exact causes of childhood leukaemia remain unknown. However, it is known that genetic changes occur in the cells within the bone marrow. 

Some risk factors increase the possibility of leukaemia:

• Genetic conditions: Children and young adults with genetic conditions such as Down syndrome have an increased risk of developing leukaemia compared to normal individuals.
• Family history: A family history of leukaemia or other cancers may raise a child’s risk, although childhood leukaemia is rarely inherited.
• Exposure to radiation: High levels of ionising radiation, such as radiation therapy used to treat other cancers can increase the risk of childhood leukaemia.

What are the symptoms?

Many childhood leukaemia symptoms can be difficult to notice, as they can be mistaken as symptoms of common illnesses. It is prudent to watch out for symptoms that persist longer than usual or are out of the ordinary.

The most common symptoms include:

• Anaemia (low red blood cell counts) symptoms – fatigue, shortness of breath, dizziness, and pale skin.
• Lack of normal white blood cells symptoms – fever and infections.
• Low blood platelet count symptoms – easy bruising and bleeding.
• Swollen lymph nodes.
• Stomach aches.
• Bone pains.
• The feeling of being unwell in general.
• Weight loss.

If your child has a darker skin tone, symptoms such as pale skin and bruising may be less evident to the eye. It is easier to notice paleness in your child’s lips, gums, tongue, and nail beds. If you gently pull down their lower eyelid, the colour of the inside will appear a shade of pale pink or white instead of red.

How is it diagnosed?

Diagnosing leukaemia in children involves a series of tests and procedures to confirm the presence of cancer cells and determine the type and extent of the disease.

The doctor will first review the child’s medical history and symptoms, including any signs of infection, bruising, or enlarged organs and conduct a physical examination to check for signs such as swollen lymph nodes, an enlarged liver or spleen, and pale skin due to anaemia.

Common tests to help diagnose leukaemia in your child include:

• Blood tests: Blood counts and blood smears are the usual first tests to be done.
• Bone marrow aspiration and biopsy: A sample of your child’s bone marrow will be extracted and examined under a microscope to detect cancerous cells and determine the type of leukaemia.
• Genetic testing: This test aims to identify the gene changes in the leukaemia cells that show which type of leukaemia affects your child. This can help doctors determine the most effective treatment and better understand your child’s prognosis.
• Lumbar puncture: A lumbar puncture involves extracting a small sample of the fluid surrounding the brain and spinal cord to determine if any leukaemia cells are present in it and also to give some chemotherapy into the fluid to prevent the spread of leukaemia cells to that area.
• Imaging tests: X-rays, CT scans, MRI, PET-CT scans or ultrasounds may be done to check for signs of leukaemia in the chest, liver, spleen, or other organs.

How is it treated?

Treatment depends on the type of leukaemia, the child’s age, overall health, and how far the disease has spread.

Chemotherapy is the main treatment. Radiation therapy is less commonly used. It is sometimes used to prevent or manage the spread of leukaemia to the brain or, in boys, to treat the testicles if the leukaemia has reached these areas. However, chemotherapy is often preferred for these cases.

Targeted therapy uses drugs that specifically target abnormal proteins or genetic mutations found in leukaemia cells, sparing normal cells. Immunotherapy involves using medications to assist a person’s immune system identify and destroy cancer cells.

A stem cell transplant (SCT), also called a bone marrow transplant, can sometimes be used. It allows doctors to administer higher doses of chemotherapy than a child would typically be able to tolerate.

What can I do to support my child with leukaemia?

Supporting a child with leukaemia involves providing both emotional and practical care throughout their treatment.

• Reassure your child by offering comfort and providing age-appropriate explanations about their treatment so they feel empowered. Be a good listener and validate their emotions.
• Stay organised with appointments, medications, and treatments.
• Work with healthcare professionals to ensure your child maintains a nutritious diet, which is essential for their strength and recovery.
• Engage your child in activities for play, creativity, and distraction to help them cope during difficult times.
• Therapy or counselling sessions for parents and child are beneficial to navigate emotional challenges.

After treatment, your child’s immune system will be low. Measles, chickenpox, and shingles can be a threat to anyone with low immunity due to cancer treatment. It is crucial to avoid close contact with these infections. If your child is showing any new symptoms after their treatment sessions, please get in touch with your doctor right away.

Symptoms of infections include:

• A high temperature (38°C or above).
• A cough or sore throat.
• Confused or restless behaviour.
• Redness, swelling, or pain in any area of the body.
• A fast heartbeat and rapid breathing.
• Unexplained fatigue or weakness.
• Painful or frequent urination.
• Diarrhoea or vomiting.

Make an appointment at Pantai Hospitals

Consult our doctors if your child is experiencing any of the symptoms above. A dedicated and expert team of Oncologists at Pantai Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding childhood leukaemia. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.