Because leukemia (Leukemia) is the most common cancer found in children, accounting for 30% of all cancers in children, today Dr. Usnaras Anuratphan, Pediatrician at Phyathai 2 Hospital has advice on caring for children with leukemia for parents, to ensure proper and appropriate patient care.
What is leukemia?
Leukemia is a condition where the bone marrow or blood stem cells work abnormally. The bone marrow produces a large number of abnormal blood cells, causing the blood system to malfunction. Lesions are usually found in the bone marrow, but the exact cause of the disease is still unknown in medicine.
Initially, it was found that patients with leukemia have some genetic abnormalities in the cancer cells. However, these genetic changes are not inherited in every cancer patient. Even if the parents do not have cancer, the child can develop cancer because the stem cells inside the child’s body change into cancer cells by themselves.
Leukemia in children can be divided into two types: present from birth or developing later in life.
What are the symptoms that indicate a child has leukemia?
Patients usually present with anemia due to low red blood cell count, fever, easy infections due to lack of white blood cells, easy bleeding due to low platelets, and other symptoms such as enlarged liver, enlarged spleen, swollen lymph nodes, arm pain, leg pain, bone pain, or joint pain.
Having leukemia… is there a chance of cure?
Leukemia does not have stages like solid tumors but is classified by the risk of relapse. This means that after treatment, patients can be cured but still have a risk of recurrence. Normally, the risk of relapse is divided into three groups: very high risk, high risk, and standard risk.
Most patients are fortunate to be in the standard risk group. For acute leukemia (ALL), the chance of cure is about 80%. For the high-risk group, the chance of cure is about 60%, and for the very high-risk group, the chance of cure is about 40%.
There is another type of leukemia in children called AML, which is divided into two groups: the standard risk group with a cure rate of 60-80%, and the high-risk group with a cure rate of about 40-50%.
What factors affect the risk of relapse?
The risk level of relapse must be assessed from several factors together as follows:
- Clinical characteristics of the patient, such as the white blood cell count measured at the time of hospital admission and how high it is
- Age at symptom onset
- Type of cancer cells
- Detected genetic abnormalities
How is leukemia diagnosed?
Leukemia is diagnosed mainly through blood tests and bone marrow examination. Patients usually have a rapid onset of symptoms. The signs and symptoms are often related to bone marrow failure and cancer cells infiltrating various tissues, disrupting the normal function of those organs, along with abnormalities caused by the large number of cancer cells in the body.
How is leukemia treated?
Treatment of leukemia mainly involves chemotherapy with multiple drugs, which requires administration through various methods such as oral medication, intravenous injection, intramuscular injection, subcutaneous injection, injection into the cerebrospinal fluid, and some cases may also involve radiation therapy. Multiple drugs are used together to help eliminate cancer cells.
Additionally, nowadays, leukemia can be cured by stem cell transplantation from donors with matching or compatible tissue types with the patient. Stem cells can be obtained from the donor’s bone marrow, peripheral blood, or from the umbilical cord blood and placenta of newborns. Donors are usually sought first among siblings with the same parents, with a 1 in 4 chance of matching.
How should families care for children with leukemia?
- First, when knowing that the child has leukemia, parents should tell the child that they have cancer because informing the patient helps them understand their illness and the need for treatment, which encourages better self-care. Cancer treatment takes a considerable amount of time, and if the patient does not know they are ill, they may not cooperate with the treatment.
- Parents should communicate about the disease, symptoms, and treatment in an age-appropriate manner to ensure cooperation in treatment and attending medical appointments.
- Attend all scheduled medical appointments.
- Chemotherapy causes complications such as nausea, vomiting, hair loss, decreased bone marrow function, reduced white and red blood cells, and low platelets, leading to anemia, easy infections, and bleeding spots. Parents should closely monitor and care for the child to prevent infections.
- If the child has a fever, they must be taken to the hospital immediately.
- Avoid crowded places or community gatherings.
- Wash hands frequently and wear a mask when going outside or in contact with the external environment.
- Eat clean and thoroughly cooked food, avoid raw vegetables and fruits because pathogens and bacteria in uncooked food can cause bloodstream infections that may be fatal.
