BENGALURU: Childhood leukemia or blood cancer, is a cancer of the white blood cells. It is the most common type of cancer found in children and teens. The abnormal white blood cells develop in the bone marrow, and rapidly travel through the bloodstream and push away healthy cells.
The incidence of childhood cancer is approximately 1 in 10,000. Leukemia is the most common type of blood cancer that affects children and teens around 0-19 years of age with peak incidence between age groups 2-5 years. As per Globocan reports 2020, over 20,000 new cases of childhood blood cancer are diagnosed every year in India, out of which nearly 15,000 cases are detected to be leukemia.
Types
Childhood leukemia includes - Acute Lymphoblastic Leukemia (ALL) - which comprises about 75% of all childhood leukemias; Acute Myelogenous (Myeloid) Leukemia (AML), Chronic Myelogenous (Myeloid) Leukemia (CML), Juvenile Myelomonocytic Leukemia (JMML) and mixed lineage leukemia.
Risk factors
Although the cause is not known, however, in few cases, the following factors may play a role.
GeneticS: The risk factors that are part of the DNA repair usually lead to leukemia, which are often inherited from parents. Children born with Down Syndrome, Klinefelter Syndrome and Li-Fraumeni -Syndrome are some of the genetic syndromes.
Immune System Suppression: Children who are treated with intensive therapies to suppress their immune systems are more prone to risk of certain cancers like lymphoma and acute lymphoblastic leukemia.
Environment: Exposure to certain radiations or nuclear power, chemical contamination of ground water and pollutants in the environment can pose the risk of getting the disease.
Diagnosis
High index of suspicion is the key to early diagnosis. Regular follow up with your paediatrician is very important.
Blood tests (CBC- complete blood count) are done to quantify the number of blood cells and their appearance.
Diagnosis of leukemia is usually confirmed by a bone marrow aspiration and/or biopsy usually done from the pelvic bone.
Pathologist also examine the blood and bone marrow samples to track the number of bloods forming cells, their type to classify the leukemia.
Treatment
Advances made in pediatric hematological and oncological disorders are one of the major game changers that have improved the cure rates and quality of life in children. The main treatment for childhood leukemia is chemotherapy. Chemotherapy is nothing but medicines used for treating cancers and they are usually given orally or through the intravenous route. Children diagnosed with high-risk leukemia, may need Allogeneic stem cell transplant (BMT) from a healthy donor. Radiation therapy is also a treatment module that is used to treat childhood cancer.
CAR T-cell therapy is another type of treatment used for relapsed and refractory leukemia. It is a form of immunotherapy. The cells are extracted out of the blood before they are changed by inserting new genes, which functions better and destroys cancer cells.
Prevention
In general, since exact causative factors are not known in childhood leukemia, preventive strategies are difficult to implement. However, certain factors like exposure to radiations, healthy lifestyle and avoiding environmental hazards will help in reducing the risk of childhood leukemia.
(The writer is consultant pediatric hemato- oncologist, HCG Cancer Hospital Bengaluru)