Understanding Acute Lymphoblastic Leukemia in Children

The first thing to know about childhood cancers is that these types of cancers are considered quite rare. However, leukemia is the most common type of childhood cancer. An estimated one out of three child and teen cancer patient are diagnosed with some form of leukemia.

The most common type of leukemia in children and teens is acute lymphoblastic leukemia. About three out of four cases of leukemia in children are acute lymphoblastic leukemia. There are two other types of leukemia in children: acute myelogenous leukemia and hybrid or mixed lineage leukemia.

Acute lymphoblastic leukemia (ALL) is a cancer that begins in the white blood cells in the bone marrow. These white blood cells, called lymphocytes, can start in early B cells (which help the body fight against germs, bacteria and viruses) or T cells (which also help the body protect itself against germs). ALL causes the bone marrow to make too many of these cells, which makes it harder for red blood cells or platelets to develop. It's much more common for B cells to develop into leukemia than T cells.

Leukemia can be either fast-growing (acute) or slow-growing (chronic). Nearly all leukemias found in children are acute. Chronic leukemias are far more commonly found in adults.

What are the Acute Lymphoblastic Leukemia Symptoms in Children?

Symptoms of leukemia in children can be the result of low red blood cell counts, low white blood cell counts, or low blood platelet counts.

Possible signs of acute lymphoblastic leukemia in children:

  • Weakness or fatigue
  • Fever, night sweats or feeling cold
  • Bruising easily or bleeding
  • Weight loss or loss of appetite
  • Stomach pain, or bone or joint pain
  • Shortness of breath
  • Pale skin
  • Pain below the ribs
  • Lumps in the neck, underarms, stomach or groin
  • Swelling of the liver or spleen

Many of these symptoms in children could be caused by something other than leukemia, such as an infection. It's important to visit a doctor if a child is displaying any of these symptoms, so that they can do a blood test to diagnose or rule out leukemia.

What is the Prognosis and Survival Rate for Childhood Acute Lymphoblastic Leukemia?

According to the American Cancer Society, the five-year survival rate for childhood acute lymphoblastic leukemia is 85 percent. There are several prognosis factors that determine the survival rate of children with ALL:

  • Children diagnosed with B-cell ALL between the ages of one and nine typically have better survival outcomes.
  • Children under 12 months, and children older than 10, are considered high-risk patients.
  • Age isn't a huge factor in the survival rates for children diagnosed with T-cell ALL.

There are many other factors that determine the outcome and prognosis for children and teen cancer patients with ALL. The age of a child and the initial white blood cell count are considered the most important factors for those diagnosed with ALL. Other factors that can potentially impact a child's prognosis include the subtype of ALL the child is diagnosed with (such as pre early B-cell or mature B-cell), gender, race or ethnicity, the spread of leukemia to certain organs, the number of chromosomes a patient has and how children respond to cancer treatments.

While learning about an initial diagnosis and prognosis for a child or teen with ALL can be difficult for parents, family members and loved ones, it's important to know that even children who are considered high-risk patients can often still be cured.

What is the Treatment for Acute Lymphoblastic Leukemia in Childhood?

For children with ALL, treatment occurs in two stages. First, a child undergoes remission induction therapy in order to kill the leukemia cells. The second stage of treatment involves maintenance therapy, which is used to kill any remaining leukemia cells. If all leukemia cells are not removed, the cells left behind could grow and cause a relapse of the cancer.

There are several treatment options for children with acute lymphoblastic leukemia:

  • Chemotherapy — The use of drugs to kill cancer cells, administered either by pill, injection or through a catheter. Chemotherapy mainly kills cancer cells, but also kills some healthy cells.
  • Radiation — Radiation therapy involves the use of radiation to shrink tumors and kill cancer cells. External radiation therapy is used to treat acute lymphoblastic leukemia. This type of treatment is typically used for leukemia that has potentially spread to the brain or spinal cord.
  • Stem Cell Transplant with Chemotherapy — This type of treatment is often used after ALL was previously treated, but has now returned. A stem cell transplant involves removing immature blood cells from the blood or bone marrow or the patient or donor. Then, stem cells are infused via the blood to restore blood cells.

Pediatric Cancer Clinics Devoted to Treating Childhood Acute Lymphoblastic Leukemia

Most children diagnosed with pediatric acute lymphoblastic leukemia undergo treatment and care at a cancer clinic that specializes in treating infants, toddlers, school-age children and teenagers. Pediatric cancer clinics are typically focused on the diagnosis, treatment and continued care of children with cancers such as leukemia and other blood disorders that occur in younger age groups.

Rocky Mountain Hospital for Children (RMHC) is a leader in the field of pediatric cancer treatment. At RMHC, children who have been diagnosed with acute lymphoblastic leukemia receive the best possible care from a dedicated team of pediatric oncologists, specialists, nurses, physician assistants. Social workers and counselors are also available to help a child and their family deal with other issues and needs related to undergoing cancer treatment. Parents and patients choose Rocky Mountain Hospital for Children for our hands-on and careful approach to treating all types of childhood cancers, making sure that each child receives individualized treatment and care.