Leukemia is a cancer that mostly affects white blood cells. White blood cells (also called leukocytes) fight infections.
Bone marrow is a spongy material inside the bones that makes white blood cells, red blood cells, and platelets. With leukemia (loo-KEE-mee-uh), the bone marrow makes white blood cells that don’t work. These abnormal cells can’t protect the body from germs. They crowd the bone marrow, enter the bloodstream, and can spread to other parts of the body, like the lymph nodes, brain, or liver.
Leukemia is the most common type of cancer in children. It can be acute (fast-growing) or chronic (slow growing). Most kids and teens treated for leukemia are cured of the disease.
Acute lymphoblastic leukemia (ALL) happens when the body makes too many of a white blood cell called a lymphocyte. This is the most common type of leukemia in children. ALL is also called acute lymphocytic leukemia and acute lymphoid leukemia.
ALL can affect different types of lymphocytes called B-cells or T-cells. Doctors label the type of ALL based on which cells are affected. Most kids with ALL have the B-cell subtype.
Acute lymphoblastic leukemia develops and gets worse quickly, so early diagnosis is important. Most kids are cured with treatment.
Kids with ALL may get anemia, which is when the body has too few red blood cells. This happens when bone marrow stops making the usual amount of red blood cells.
Kids with anemia may:
When they don’t have enough platelets (PLATE-lits), kids with leukemia may bruise easily, get nosebleeds, or bleed for a long time after even a minor cut.
Other symptoms of leukemia can include:
Because their white blood cells can't fight infections, kids with leukemia are more likely to get viral or bacterial infections.
Sometimes leukemia can spread, or metastasize (meh-TASS-tuh-size). If it spreads to the brain, symptoms may include headaches, seizures, balance problems, or vision problems. If it spreads to the lymph nodes in the chest, symptoms can include breathing problems and chest pain.
Doctors don't know exactly what causes leukemia. But some things can make kids more likely to get it, such as:
Doctors use special tests to check for leukemia. These include:
Most kids with ALL will get chemotherapy. These are special drugs that kill cancer cells. Which drugs a child gets and in what combination depends on the subtype of ALL and how fast-moving the disease is. How cancer cells respond to the first treatment helps doctors decide how to choose the next type of chemo.
Different types of chemo can be given:
The treatment goal is remission, which is when tests don't find any cancer cells in the body. Then, maintenance chemotherapy keeps the child in remission and prevents the cancer from coming back. Kids get maintenance chemo for 2 to 3 years.
Some kids who have a fast-growing type of ALL might need a stem cell transplant (sometimes called a bone marrow transplant). This treatment involves:
Other treatments may include:
Clinical trials are research studies that offer promising new treatments not yet available to the public. Doctors will decide if a child is a good candidate for a clinical trial.
Having a child being treated for cancer can feel overwhelming for any family. But you're not alone. To find support, talk to anyone on your child’s care team or a hospital social worker. Many resources are available to help you get through this difficult time.
You also can find information and support online at:
Reviewed by: Larissa Hirsch, MD
Date Reviewed: Oct 11, 2021