Leukemia in Children.

Abstract

1. Joel A. Kaplan, DO, MPH 1. Department of Pediatrics, Atrium Health Levine Children’s Hospital, Charlotte, NC * Abbreviations: ALL: : acute lymphoblastic leukemia AML: : acute myelogenous leukemia BMT: : bone marrow transplant CBC: : complete blood cell CML: : chronic myelogenous leukemia CNS: : central nervous system DIC: : disseminated intravascular coagulation EFS: : event-free survival HLA: : human leukocyte antigen MRD: : minimal residual disease Ph: : Philadelphia chromosome TKI: : tyrosine kinase inhibitor WBC: : white blood cell Persistent bone pain, limp, back pain, fever, headache, and symptoms of anemia and thrombocytopenia are common ways that pediatric leukemia presents. Many of these symptoms can be seen in common childhood illnesses, so a high index of suspicion in patients with persistent symptoms is required to make the diagnosis. The prognosis for these children is excellent, especially in acute lymphoblastic leukemia, but survivors of childhood leukemia need to be followed closely for long-term toxicities. After completing this article, readers should be able to: 1. Understand the incidence and general epidemiology of childhood leukemia, including syndromes that increase the risk of leukemia in children. 2. Recognize the clinical presentation of childhood leukemia and how this relates to proper interpretation of a complete blood cell count. 3. Understand the potential oncologic emergencies in childhood leukemia. 4. Describe the prognostic factors associated with precursor B-lymphoblastic leukemia, including an understanding of the importance of minimal residual disease. 5. Understand the importance of supportive care in the treatment of childhood acute myelogenous leukemia. 6. Describe the long-term complications of childhood leukemia treatment in the modern era. Leukemia is the most common malignancy of childhood, accounting for 30% of cases of childhood cancer. Although there are some associations between environmental or host factors, most leukemia diagnoses in children are sporadic. There are 3 main subtypes of leukemia: acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML). ALL is the most common subtype, accounting for approximately 80% of cases. CML is the least common, and this review touches on this subtype only briefly. There are many subgroups within ALL and AML. These subgroups have variable biological features, prognoses, and treatment regimens. Children …