What is Leukaemia?
Leukaemia is a cancer of the white blood cells. There are four main
types of leukaemia:
- acute lymphoblastic (ALL)
- acute myeloid (AML)
- chronic lymphocytic (CLL)
- chronic myeloid (CML).
One third of all childhood cancers are leukaemia, and there are approximately 400 new cases occurring each year in the UK.
Acute lymphoblastic leukaemia is the most common type of leukaemia in children - it accounts for more than 80 per cent of cases. Acute myeloid leukaemia (AML) is the less common type of leukaemia found in children. Chronic leukaemias (CLL and CML) occur mostly in adults and are extremely rare in children and young people.
Acute lymphocytic leukaemia can affect children at any age, but is more common in younger children under the age of four years. It is also more common in boys than in girls. Acute myeloid leukaemia can affect children of any age with boys and girls being affected equally.
What causes leukaemia?
Blood cells are produced in the bone marrow - a sponge-like tissue that is found inside bones. White blood cells are made to help fight infection. Normally they are produced in a very controlled way, but in leukaemia these cells are produced in excessive amounts and are unable to work properly.
It is not known exactly why some children develop leukaemia while others don't. Leukaemia is, however, more likely to be seen in children who have other genetic conditions, such as Down syndrome. Leukaemia, as with any other cancer, is not infectious and cannot be passed on to other people.
What are the signs and symptoms of leukaemia?
At first the symptoms are just like those of a viral infection. The child is likely to feel generally unwell and may complain of aching limbs.
As the white blood cells build up, the bone marrow is then unable to make enough of the healthy red blood cells and platelets, so this affects how oxygen is carried around the body and how the blood clots. Children may start to become very tired and lethargic due to anemia from the lack of red blood cells. As the clotting of their blood becomes affected by the low numbers of platelets in their blood, they tend to bruise easily. They may also suffer from an increased number of infections due to the low numbers of healthy white blood cells. They may also have swollen lymph glands.
How is leukaemia treated?
As childhood leukaemias tend to develop quite rapidly, most children will start treatment soon after they are diagnosed. The aim of the treatment for both ALL and AML is to achieve a state called remission - this is where the leukaemia cells have all been destroyed and the bone marrow is working as normal. Chemotherapy is the main treatment for leukaemia. These medicines are usually given in 'blocks' of treatment over a period of time.
Some children may also need radiotherapy treatment. For some, the leukaemia may come back after treatment and they may need a bone marrow transplant. Once the child has achieved remission, they receive maintenance treatment. This is given over a period of two to three years to stop the leukaemia from recurring.
Unfortunately, many cancer treatments cause unpleasant side effects. This is because, while the treatments aim to kill off the cancer cells, they also damage healthy cells too. Common side effects include nausea and vomiting, hair loss, loss of appetite, bleeding and an increased risk of infection. Most are temporary, but a small number of children can develop side effects to treatment in the longer term.
Caring for a child with leukaemia in a childcare setting
A child with leukaemia is likely to need to spend periods of time away from the childcare setting, particularly during the early stages of their illness when are receiving treatment in hospital. However, many children will be well enough to return after their initial blocks of treatment.
It is important that staff work with parents to understand how leukaemia is affecting the child. They may be tired and their energy levels may fluctuate from day to day; this will obviously have an impact on how much they can do. Their immune system may also be weakened, so it is important that parents are immediately notified of any contagious illness within the childcare setting.
FURTHER INFORMATION
- CLIC Sargent on 0800 197 0068 or www.clicsargent.org.uk
- Children with Leukaemia on 020 7404 0808, or www.leukaemia.org