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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.
Feeling weak or tired
Bone pain or limping
Bleeding and bruising easily
Swelling in the abdomen
Swollen lymph nodes
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
• 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.
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
American Academy of Pediatrics 847/434-4000 http://www.aap.org
National Cancer Institute 800/4-CANCER (800/422-6237) http://www.cancer.gov
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,
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are appropriate in most instances, but they are not a substitute for medical
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TOPIC: CHILDHOOD ILLNESSES
Parmet S, Lynm C, Glass RM. Childhood Leukemia. JAMA. 2004;291(4):514. doi:10.1001/jama.291.4.514