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JAMA Patient Page
January 28, 2004

Childhood Leukemia

JAMA. 2004;291(4):514. doi:10.1001/jama.291.4.514

Leukemia is cancer of the white blood cells, which play an important role in fighting infections. All blood cells are produced in the bone marrow—the spongy tissue in the center of bones. When a child has leukemia, too many abnormal early-stage white blood cells are produced. This can interfere with the production of red blood cells (which carry oxygen) and platelets (which help blood clot). The abnormal white blood cells can damage the function of many different organs and tissues and can also invade the spinal fluid. Leukemia can occur in children of all ages but affects boys more often than girls. Leukemia is believed to be caused by genetic mutations—abnormal changes in the genes of blood cells. Leukemia is not contagious and does not generally run in families. The January 28, 2004, issue of JAMA includes an article about clinical trials for children with leukemia.


  • Fever

  • Frequent infections

  • Feeling weak or tired

  • Bone pain or limping

  • Headache

  • Bleeding and bruising easily

  • Swelling in the abdomen

  • Swollen lymph nodes

  • Poor appetite


If a child has symptoms of leukemia, a doctor will perform a physical examination and order blood tests to see if there is an excess of abnormal white blood cells. Other diagnostic procedures include

  • Bone marrow aspirate/biopsy—a sample of bone marrow is taken using a needle and examined for signs of leukemia;

  • Lumbar puncture—spinal fluid is collected through a needle to see if leukemia has spread to the spine and brain.


• Chemotherapy—drugs used to kill cancer cells. Chemotherapy may be taken orally (by mouth), intramuscularly (injection into a muscle), or intravenously (through a vein).

• Radiation therapy—high-energy rays produced by a machine are used to kill cancer cells.

• Bone marrow transplantation—after radiation and/or chemotherapy is used to destroy all the abnormal bone marrow, healthy bone marrow from a donor is given to the patient through a vein. Most cases of childhood leukemia do not require bone marrow transplantation.

Clinical trials

In the United States, about two thirds of children with leukemia enroll in a clinical trial. Clinical trials are studies in which researchers determine whether new drugs or treatments are better than the best current standard therapy. During clinical trials, researchers collect information on how well the therapy works or does not work and what the adverse effects of the various treatments are.

For more information

Inform yourself

To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on clinical trials was published in the February 7, 2001, issue of JAMA; and one on leukemia was published in the August 22/29, 2001, issue.

Sources: American Academy of Pediatrics, National Cancer Institute, Nemours Foundation

The JAMA Patient Page is a public service of JAMA. The information and recommendations
appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.