Childhood Leukemia

Introduction:

 There are three more common acute childhood leukemias, acute lymphoblastic leukemia (ALL), acute myelogenous leukemia(AML) and non-Hodgkin's lymphoma (NHL). I apologize for the complex doctor terminology and the abbreviations. However, these terms are what anyone, who gets involved with the treatment of such a condition, will hear a lot in doctor's offices and hospitals.

Causes of leukemia:

Acute leukemia is the most common malignancy in children. It occurs in the bone marrow and may be common in childhood because the bones are experiencing a lot of changes with normal growth. 75% of the 2000 cases of childhood leukemia are ALL, 20% are AML and about 5% are NHL. The peak in incidence for ALL is between 2 and 6 years of age. It occurs more often in boys than in girls and is not observed in blacks. AML occurs more often in girls between the ages of 5 and 15 years. Beyond the age of 15 years boys are affected more commonly with AML.

   Chronic benzene exposure, a chemical that is used in industry for the production of detergents, plastic manufacturing, insecticides and others, is a known cause of leukemia, mainly AML. There is an increased risk for children to develop leukemia when the fetus is exposed to diagnostic X rays when a woman is in a first trimester pregnancy. There is a hint that there likely is a genetic problem concerning the development of leukemia as Down syndrome (trisomy 21) has a 15-fold risk to develop leukemia than normal children do.

There are other rare genetic abnormalities of which some are associated with a higher risk of leukemia. Finally, there is a link to certain viral infections such as Epstein-Barr virus, which can cause Burkitts lymphoma (if the population is starved as in Africa). On the other hand HTLV is a virus where two subtypes, HTLV-I and HTLV-II, have been characterized in the meantime and that have been associated with certain human leukemias. There are also many myths that could not be proven: for instance living near high voltage power line does not seem to cause leukemia. In the early days of neon lights there were reports of leukemia from unsafe neon light bulbs in school classes. It turned out that there had been a manufacturing problem where light bulbs were emitting X rays and the chronic exposure to X rays led to leukemia. This has not been a problem for decades, because manufacturers have strict controls to ensure this cannot happen again. But the myth (from a fact in the past) lives on.

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles &Practice of Oncology. 4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Acute Leukemia.

2. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Acute Leukemia.

3. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc

Last Modified: Jan. 30, 2012