The exact cause of acute lymphoblastic leukemia (ALL) in children is unknown, but researchers link the disease to chemical exposure in early childhood or before birth, viruses, or exposure to radiation. They believe these factors may cause genetic mutations that lead to acute lymphoblastic leukemia. In children, the disease begins when genes connected to chromosomes break off and attach to other chromosomes. Cells in the DNA develop lymphoblasts, defined as immature white blood cells.
Signs of acute lymphoblastic leukemia in children include bruising or bleeding easily from normal activity. The child may lose his or her appetite and frequently feel weak and tired. Pain might appear in the joints, along with lumps in the groin, stomach, neck, or armpits, accompanied by fever. Some patients develop red spots on the skin from bleeding that does not surface.
Several tests are used to diagnose acute lymphoblastic leukemia in children who develop one or more symptoms. Doctors typically test the blood for red blood cells, white blood cells, and platelets, along with measuring the level of hemoglobin. A bone marrow test uses a hollow needle to remove a small amount of bone and bone marrow that can be tested in a laboratory for cancer.
Another diagnostic test detects chromosomal changes in a blood sample when viewed under a microscope. Bone marrow can also be aspirated and checked for malignant lymphocytes by a pathologist. In some cancer patients, a chest x-ray reveals signs of acute lymphoblastic leukemia in children.
Treatment typically occurs in three phases using chemotherapy and radiation with other drugs, called induction therapy. The first phase kills all cancer cells and puts the child into remission, which usually happens within a month. The second phase ensures all cancer is killed to prevent a relapse. The third and final stage of leukemia treatment involves maintenance doses of the drugs and chemotherapy.
Side effects of ALL treatment include kidney or liver damage. A child’s blood might clot abnormally after exposure to the drugs and chemicals used to treat cancer. Very young children who are thin might develop low blood sugar after therapy, while calcium levels in the blood might increase in others.
The prognosis for complete recovery from acute lymphoblastic leukemia in children depends on the age of the child when he or she was diagnosed and his or her white blood cell count. If the child does well during initial treatment, he or she stands a better chance of recovering from the disease. The prognosis for a complete cure declines if the cancer spreads to the brain or spinal cord. Children with Down syndrome face a higher risk of developing ALL.