Recognizing the Symptoms of Leukemia in Children

Symptoms of leukemia in children usually present as unexplained fever, persistent fatigue, pale skin, and unexplained bruising on various parts of the body. As the most common type of childhood cancer, leukemia has a very high treatment success rate when diagnosed early. Reading your child's body signals correctly and consulting a specialist without delay is the most crucial step in the treatment journey.

• Leukemia is a blood cancer caused by the uncontrolled multiplication of blood cells in the bone marrow.
• The most common symptoms include fatigue, bone pain, frequent infections, and loss of appetite.
• Acute Lymphoblastic Leukemia (ALL) is the most frequent type seen in children.
• Blood tests and a bone marrow biopsy are required for a definitive diagnosis.
• The primary treatment method is chemotherapy, and success rates are quite high.

What is Childhood Leukemia?

Leukemia, commonly known as blood cancer, is a disorder that occurs during the production of blood cells in the bone marrow. A healthy bone marrow regularly produces white blood cells that fight infections, red blood cells that carry oxygen, and platelets that stop bleeding. However, in the case of leukemia, the bone marrow begins to produce abnormal white blood cells (blasts). These abnormal cells multiply rapidly, replacing healthy cells and preventing the body from performing its normal functions.

Childhood leukemia accounts for about one-third of all pediatric cancer cases. The disease usually starts suddenly and progresses rapidly, which is why noticing the symptoms is vital. Leukemia weakens the child's immune system, leaving them vulnerable to external threats.

Types of Childhood Leukemia

Leukemias seen in children are generally acute (fast-progressing) in nature. The most common type, making up about 75-80% of cases, is Acute Lymphoblastic Leukemia (ALL). It is most frequently seen in children between the ages of 2 and 5. The second most common type is Acute Myeloid Leukemia (AML). While AML can occur in any age group, it is slightly more common during the first two years of life and adolescence. Chronic leukemia types are quite rare in childhood.

Causes and Risk Factors

The exact cause of leukemia in children is often unknown. The disease arises from mutations in the DNA of bone marrow cells. How and why these genetic changes begin is still being researched in the medical world. However, unlike adult cancers, there is no proven direct link between environmental factors or lifestyle (such as diet or exposure to cigarette smoke) and childhood leukemias.

That said, certain risk factors are known to increase the likelihood of developing leukemia. Children with specific genetic variations, such as Down syndrome, have a higher risk compared to other children. Additionally, congenital immune system disorders or having received high-dose radiation or chemotherapy for another illness in the past are also considered risk factors. Genetic predispositions, such as a family history of leukemia or having an identical twin with the disease, can also play a rare role.

Symptoms of Leukemia in Children

Symptoms of leukemia in children emerge due to the decrease in healthy blood cells in the bone marrow. These signs can be very mild at first and easily confused with a common cold, the flu, or other typical childhood illnesses. As the disease progresses, the severity of the complaints increases and becomes more noticeable.

The type and severity of symptoms can vary depending on the type of leukemia and where the abnormal cells have spread in the body. Complaints that last for weeks and cannot be attributed to a known infection should be monitored closely.

Most Common Symptoms

Among the signs of blood cancer in children, parents should pay closest attention to the following:

• Fever and Frequent Infections: Due to the lack of healthy white blood cells, the body cannot fight infections. You might notice a persistent or recurring fever that does not respond to antibiotics, which can sometimes be confused with winter ailments common in Türkiye like the RSV virus.
• Fatigue and Pale Skin: A decrease in red blood cells leads to anemia. The child may look much paler than normal, tire easily, and lose interest in playing games.
• Bleeding and Bruising: A lack of platelets impairs blood clotting. Bruises appearing on the child's legs, arms, or torso without any bumps, as well as hard-to-stop nosebleeds and bleeding gums, are frequently experienced.
• Bone and Joint Pain: The accumulation of leukemia cells in the bone marrow causes it to expand, leading to severe pain. This condition should not be confused with back pain in children or normal growing pains.
• Loss of Appetite and Abdominal Swelling: Leukemia cells can build up in the liver and spleen, causing these organs to enlarge. This creates a swollen abdomen, a feeling of fullness, and noticeable weight loss.

How is it Diagnosed?

Answering how leukemia is detected involves a detailed physical examination and specific laboratory tests. The physician first listens to the child's medical history and checks for enlarged lymph nodes, liver, or spleen. Bruising and paleness on the skin are also evaluated during the exam.

The first step is usually a complete blood count (CBC) and a peripheral blood smear (examining the blood under a microscope). These tests check the numbers of red blood cells, white blood cells, and platelets; they also look for the presence of abnormal leukemia cells (blasts) in the blood. If suspicious findings are encountered in the blood tests, a bone marrow aspiration and biopsy are performed for a definitive diagnosis. To ensure the child feels no pain, this procedure is typically done under mild anesthesia by taking a small fluid and tissue sample from the hip bone. The collected samples are examined in a pathology laboratory to precisely determine the type and subtype of leukemia.

Pediatric Leukemia Treatment

Pediatric leukemia treatment is specially planned according to the type of disease, the child's age, and overall health status. The cornerstone of treatment is chemotherapy. The chemotherapy process generally consists of several phases: remission induction (destroying cancer cells to push the disease into remission), consolidation (clearing any remaining hidden cells), and maintenance (preventing the disease from returning). Treatment usually lasts 2 to 3 years.

In some cases, especially in high-risk leukemia types or scenarios where the disease relapses, a bone marrow transplant (stem cell transplant) may be necessary. In this procedure, the diseased bone marrow is completely emptied with high-dose chemotherapy and replaced with healthy stem cells from a donor. Additionally, innovative methods like targeted therapies and immunotherapy have offered promising results in pediatric oncology in recent years. Receiving psychological support for the child and the family during the treatment process plays a massive role in getting through this challenging period.

Complications and Risk Groups

Leukemia and the intensive treatments applied can lead to various complications in children's bodies. The greatest risk is severe infections arising from the deep suppression of the immune system during chemotherapy. During this time, even a simple cold can pose a life-threatening risk. Furthermore, internal bleeding risks due to low platelets must be closely monitored.

Long-term complications include slowed bone development, sensitivity in heart or kidney functions, and, rarely, the risk of developing secondary cancers. Therefore, children who have completed leukemia treatment must be followed up at regular intervals for years. Infants under 1 year of age and children over 10 are considered among the risk groups that need closer monitoring regarding their response to treatment.

When to Seek Immediate Medical Attention?

Certain symptoms in children suspected of having leukemia or currently undergoing treatment require urgent medical intervention. If you notice a sudden deterioration in your child's general condition, you should apply to a healthcare facility without delay.

You should immediately call 112 (the national emergency number in Türkiye) or go to the nearest emergency room in the following situations:

• Persistent fever over 38.5°C that does not drop despite antipyretics.
• Unstoppable nosebleeds or blood in the stool/urine.
• Widespread, pinhead-sized red/purple spots (petechiae) suddenly appearing on the skin.
• Difficulty breathing, rapid breathing, or chest pain.
• The child being too lethargic to wake up, experiencing a severe headache, or showing signs of confusion.

The Process at BHT CLINIC

Childhood cancers require a delicate process involving a multidisciplinary approach and advanced technology. The Department of Pediatrics at BHT CLINIC İstanbul Tema Hastanesi, located in Küçükçekmece, stands by you with its experienced staff for all kinds of health issues your children may face during your stay in Türkiye. When suspicious findings are detected, all necessary blood tests and imaging scans are organized swiftly.

Our hospital's 24/7 emergency department offers immediate intervention capabilities for emergencies like febrile illnesses or unexpected bleeding. If you have concerns about your child's health, you can contact our hospital to get support from our specialist physicians. Knowing that early diagnosis saves lives, it is crucial to have any doubtful symptoms medically evaluated without postponement.

Frequently Asked Questions

The leukemia journey can be highly concerning for parents. Below, you can find answers to the most frequently asked questions on the subject.

At what age is leukemia most common in children?

Childhood leukemia most frequently appears in children between the ages of 2 and 5. However, there is a possibility of it occurring in any age group, from infancy to adolescence.

Is leukemia genetic? Can it be passed to siblings?

Leukemia is mostly not a hereditary disease, and genetic transmission from the family is very rare. Having one child with leukemia does not mean their siblings will definitely develop it too.

Do blood cancer symptoms in children start suddenly?

In acute leukemias, symptoms generally develop quite rapidly, over a matter of weeks. A child suddenly becoming lethargic, turning pale, and developing bruises on their body is a typical onset.

How long does leukemia treatment take?

Pediatric leukemia treatment typically lasts between 2 and 3 years, depending on the type of disease and the risk group. While the initial months of this process are more intensely spent in the hospital, it later transitions to maintenance therapy followed from home.

Is leg pain always a symptom of leukemia?

No, leg pain in children is often caused by innocent growing pains. However, if the pain is accompanied by fever, fatigue, bruising, or weight loss, it must be evaluated by a physician.

We wish you healthy days. For appointments and detailed information, you can visit our BHT CLINIC online appointment page or reach us at our call center at +90 850 811 34 00.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.