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Kathryn Jones
Mrs. Oorlog
Advanced Composition
December 21 2012
Childhood Leukemia
With all the focus on woman's breast cancer, people tend to forget that childhood
leukemia leads to death more than any other childhood cancer. My goal is to educate as
to the truth about childhood leukemia and the advancements in treatment. Most people
when thinking of “childhood cancer” envisions very young children, although, The
Children’s Hospital of Philadelphia states that “Leukemia can occur at any age, but is
most commonly seen in children aged two to six years” (Lange 1). So today, I am going
to inform you on what ALL does to a patient, the side effects, causes and the
treatments.
Leukemia is a cancer of the bone marrow and blood and is the most common
type of childhood cancer (Langue 1). Since leukemia takes place in the bone marrow,
the bone marrow being a soft spongy center of the bones that produces the three types
of blood cells, most symptoms include those of irregular bone marrow function. Anemia
is a symptom that may make a child tired, pale, and breathe faster. Anemia is a medical
condition in which the red blood cell count hemoglobin is less than normal (Langue 2).
Another symptom is recurring infections including fever, runny nose, and coughing.
Some patients may also experience abdominal distress which may cause loss of
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appetite and weight loss (Langue 2). Other symptoms may be difficulty breathing,
swollen lymph nodes, bond and joint pain and bleeding or bruising (Langue 2).
A specific type of leukemia is ALL, all starts in the white blood cells and can
spread out to other organs in the body such as the liver or the spleen. Since ALL is an
acute type of Leukemia it can progress fast and can be fatal within a few months
(HealthWise 1). ALL has many of the same symptoms as all other cancers but ALL
does not produce tumors like some of the cancers do which makes it harder to detect.
ALL has the same risk factors as many other cancers but ALL affects males most of the
time (HealthWise 1). The prognosis for cancer patients depends on many factors.
Experts don’t know the cause of ALL but there are things that increase the risk of
getting Leukemia and those things are called risk factors (HealthWise 2).Being exposed
to large amounts of radiation, genetic problems and smoke are huge risk factors of
Leukemia (HealthWise). The majority of cases for children are caused by acquired
genetic diseases. That means that leukemia is nonhereditary, but that gene mutations
and chromosomes abnormalities in cells happen by chance. A big cause of getting ALL
is having a weak immune system. If someone was to have a defect in their immune
system it would increase the chance of developing leukemia because they can’t fight off
any infections or bacteria in their body like a normal immune system can.
With symptoms being nonspecific and the causes of ALL are unknown, being
diagnosed may involve a long process. The process usually beings with a physical
examination. During the physical examination a pediatrician does everything a normal
doctor does. Listens to the breathing, checks weight, most of the times the doctors will
check for any bruising, or anemia side effects ( Kanwar 1) After examine the patient the
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pediatrician will determine if what is acute lymphoblastic leukemia (ALL) or include
acute myelogenous leukemia (AML). ALL is the most common type of leukemia for
children (HealthWise 1).
One of the ways doctors can see if a child has cancer is through blood tests. A
complete blood count (CBC) can show how the blood is clotting, conduct genetic
studies and evaluate the organs such as the kidney or liver. When collecting the blood
doctors either use a needle or a central venous line. A central venous line is a plastic
tube or catheter which is inserted into a large vein in the chest neck or arm. Using the
central line prevents numerous needle sticks (Langue 3). Another way to see if a has
cancer is by testing bone marrow. For bone marrow test the doctor inserts a needle into
a bone in the pelvis or spine. From this site, the doctor collects two teaspoons for
examination (Langue 3).
Many people forget that acute lymphoblastic leukemia (ALL) is one of the top
cancers that are fatal to young children and even adults. The most common type of
childhood cancer, acute lymphoblastic leukemia (ALL), accounts for about three out of
four cases of cancer in children. In one day 57 people die due to ALL, in one year the
amount of people that die is 21,000 (Simon 3). Although today, the survival rate has
gone up people don’t realize that in the 1960s the five year survival rate was less than
ten percent (Simon 4). With new technology and more information about the treatment
given, the survival rate from 1990 to 1994 jumped to 83.7%. Researchers through
clinical trials helped doctors learn about the best drugs and treatments to use for those
with ALL (Simon 5).
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ALL is one of the most curable cancers and survival rates are now at an all time
high (Simon 1). Age is a huge factor on the survival rate for a patient with ALL. Younger
patients are more likely to survive ALL, those that are older than ten years have a
poorer outcome than those younger than nine years of age. Patients with a higher white
blood count (WBC) tend to not do better than patients with a WBC under 50,000 (Simon
1).Many patients who have complete remission (showing no signs of cancer) after
enduring chemotherapy have a better prognosis than those who been doing
chemotherapy longer or have had no signs of remission. Ninety-five percent of ALL
patients attain remission (Simon 1). Some sources say that males have a less chance
fighting cancer than females because of their risk of getting testicular cancer.
Responding to treatment right away is a good sign regardless of the risk factors.
The advancement in treatment has increased greatly over the years which give
many more patients a higher recovery rate. A spinal tap is one way for doctors to give
treatment to a patient. A spinal tap is a lot like the bone marrow but instead of the
needle going into the pelvis or spine, the needle would be inserted into the lower back
between the bones of spinal column or backbone to insert medicines to prevent or treat
leukemia in the brain or spinal cord. The doctors could also remove the fluid that
surrounds the brain and spinal cord for examination to determine if someone has cancer
(Langue 3). The most common type of cancer treatment is chemotherapy. Everyone
has a basic idea of what chemo does for a patient Chemotherapy is either given in the
mouth, vein, and muscle or under the skin (Langue 4). Intrathecal chemotherapy is
chemotherapy that is injected into the spinal fluid to prevent or treat leukemia. Another
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form of treatment is radiation therapy. Radiation therapy uses high energy waves such
as x-rays to kill or shrink cancer cells (Langue 4).
The final and one of the most complicated forms of treatment is blood and
marrow transplantation. The first step for the transplantation is to get a collection of
healthy stem cells from a donor without cancer or from the patient. The next step would
be to administrated high doses of chemotherapy and possibly radiation therapy to kill
any remaining leukemia cells. And the final step would be the infusing of the healthy
stem cells through an intravenous line to produce normal blood-forming cells. A bone
marrow or stem cell transplant is commonly uses to treat ALL that has not responded to
chemo. All of this information comes from The Children’s Hospital of Philadelphia, page
4.
The steps of the treatment stages can take months or years to complete. The
beginning of the stages is induction. In this stage the main goal is to reduce the number
of leukemia cells in the marrow to less than 1 in 20 which is five percent. This takes
place in the first month where chemotherapeutic drugs are given (Langue 4). The
second step is Consolidation. In this step it takes one or two months of drug treatment
because leukemia cells are still present in the body even though they might not show up
in a blood test or bone marrow examination. The next step is intensification. Here there
is a repeat in chemotherapy combination similar to those used in induction and
consolidation. It may involve bone marrow or stem cell transplantation or higher-dose of
chemo (Langue 5). The final step is maintenance; during the maintenance step the goal
is to reduce the leukemia cells further by using repeated courses of less intense chemo.
This repeated course is every 28 days for an additional eighteen months in girls and
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thirty months in boys. Regular outpatient visits are required to see the response to
treatment, detect any recurrent disease and manage any side effects of the treatment
(Langue 5).
There are much advancement in technology that allows us to determine if a child
has leukemia and to help treat the leukemic cells. One of the technologies doctors use
today is to see pre-leukemic cells that are present at birth with children later diagnosed
with ALL up to age 13 (Brisbane 1). Blood spots collected at birth has show seventy
percent of children with the most common form of childhood leukemia (ALL), had
molecular evidence of their cancer from day one (Brisbane 1). Another technology they
use is a small device that looks like a small microphone, called a probe, ultrasound
waves are directed into the abdomen. These sound waves bounce back to the probe at
different rates, depending upon the tissue encountered in their pathway. The returning
sound waves are analyzed by a computer to generate detailed images of the organs in
the abdomen. In patients with leukemia, ultrasound may be used to evaluate the
condition of the spleen and other internal organs that may have been affected by the
disease (May Clinic 2). There are many other technology’s that help doctors determine
if a patient has cancer or if they will effected by cancer later on in life.
In conclusion, there are many facts and different stages about childhood
leukemia. Many people don’t understand all the steps that a child has to go through just
because they were diagnosed with cancer. There are many children in the US today
that go through this there whole life, in and out of hospitals just so they can recover from
this disease. With all the new technologies we have many more patients will be able to
recover from leukemia.
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