Leukemia is cancer
of the blood and develops in the bone marrow. It is the most common form of
cancer in children.
Children and teens with leukemia are treated at Dana-Farber/Boston Children's through our Hematologic Malignancy Center's Leukemia Program. Dana-Farber/Boston Children’s has played a key role in refining treatment for childhood leukemia, and we continue to be a world leader in leukemia clinical trials designed to increase cure rates, decrease treatment-related side effects and improve care for long-term survivors. The Leukemia Program also offers families the chance to have their child's leukemia cells molecularly profiled, which may help identify opportunities for targeted treatment.
is cancer of the blood and develops in the bone marrow. The bone marrow is the
soft, spongy center of the long bones that produces the three major blood
cells: white blood cells to fight infection; red blood cells that carry oxygen;
and platelets that help the blood clot and stop bleeding. When a child has
leukemia, the bone marrow, for an unknown reason, begins to make white blood
cells that do not mature correctly but continuously reproduce. Normal, healthy
cells only reproduce when there is enough space for them to fit.
body can regulate the production of cells by sending signals when to stop. With
leukemia, these cells do not respond to the signals to stop reproducing,
regardless of space available. These abnormal cells reproduce very quickly and
do not function as healthy white blood cells to help fight infection. When the
immature white blood cells, called blasts, begin to crowd out other healthy
cells in the bone marrow, the child experiences the symptoms of childhood
nearly all cases, it is not known what causes leukemia. The majority of
childhood leukemias are acquired genetic diseases. This means that gene
mutations and chromosome abnormalities in leukemia cells occur sporadically (by
chance). The abnormalities found in leukemia cells are not found in the other
cells of the body.
What role does the immune system play in leukemia?
The immune system plays an important role in protecting the body from
disease and possibly cancer. An alteration or defect in the immune system may
increase the risk for developing leukemia. Factors such as exposure to certain
viruses, environmental factors, chemical exposures, and infections have been
associated with damage to the immune system, but none of these factors has been
definitively linked as a cause of childhood leukemia.
It’s important to understand that leukemias most often occur for no
known reason, and in nearly all cases, its cause cannot be determined. There’s
nothing that you could have done or avoided doing that would have prevented the
disease from developing. In the majority of childhood leukemias, gene mutations
and chromosome abnormalities in the leukemia cells occur by chance. The
abnormalities found in leukemia cells are not found in the other cells of the
What determines the type of leukemia my child has?
The type of childhood leukemia (lymphoblastic or myeloid) is determined
by the type of bone marrow cell from which the cancer develops.
cells start out as hematopoietic stem cells, which means they can develop into
any type of blood cell. When leukemia develops from a stem cell, it is
typically chronic myelogenous leukemia (CML).
Early in its
development, the stem cell becomes either a lymphocyte precursor cell or a
myeloid precursor cell. Acute lymphoblastic leukemia (ALL) is the type of cancer
that develops from a lymphocyte precursor cell. Acute myelogenous leukemia
(AML) is the type of cancer cell that develops from myeloid precursor cells.
In addition to a complete medical history and physical examination, leukemia diagnostic procedures may include:
The specific leukemia treatment for your child will be determined by your child's physician based
treatment usually begins by addressing the presenting symptoms such as anemia,
bleeding, and/or infection. In addition, leukemia treatment may include
(alone or in combination):
What is relapse?
leukemia may occur even with aggressive therapy. Relapse is when the bone
marrow begins making abnormal cells again. Relapse can occur during any of the
stages of treatment or may occur months or years after treatment has ended.
(Learn about relapsed acute lymphoblastic leukemia.)
There are various stages in the leukemia treatment, including the following:
greatly depends on:
with any cancer, prognosis and long-term survival
can vary greatly from child to child. Prompt medical attention and aggressive
therapy are important for the best prognosis.
Continuous follow-up care is
essential for any child diagnosed with leukemia. Side effects of radiation and chemotherapy, as
well as second malignancies, can occur in survivors of leukemia. New methods
are continually being discovered to improve treatment and to decrease side
effects of the treatment for the disease.
Survivorship care is important for patients with leukemia in remission. Our weekly cancer survivorship clinic, which set the national standard for childhood cancer survivorship care, offers ongoing care to manage late effects caused by your child’s cancer or the treatment they received.
Phone: 617-632-5508Online form: Request an appointment
World class cancer care at the #1 children's hospital
Kimberly Stegmaier, MD, discusses
current research aimed at finding new drug targets for children with
leukemia and other cancers.
CAR (chimeric antigen receptor) T-cell therapy is a promising new treatment for some of the most challenging cases we face in pediatric acute lymphoblastic leukemia (ALL).