Leukemia stands out as the most common type of cancer in childhood. Leukemia accounts for 35% of childhood cancer cases, with Acute Lymphoblastic Leukemia (ALL) being the most prevalent type, studied under two main groups alongside Acute Myeloblastic Leukemia (AML). Every year in Turkey, 1,200-1,500 children under the age of 16 are newly diagnosed with leukemia. Although the exact causes of leukemia are not yet fully known, factors such as genetic predispositions, radiation, chemical substances (such as benzene), insecticides, and certain hereditary and viral diseases are thought to potentially lead to leukemia. Despite being potentially present at any age, the disease most commonly appears in children aged 2-5. Notably, cases under the age of 1 and over 10 show more challenging responses to treatment.
What Are the Symptoms of Leukemia?
Leukemia may initially present certain symptoms. The most common symptoms in children include loss of appetite, anemia, weight loss, bone pain in the legs, bleeding under the skin, nose and gum bleeding, and fever. Leukemia can affect the bone marrow, as well as the lymph nodes, spleen, liver, and central nervous system. Therefore, depending on the organs affected by the spread of the disease, symptoms such as headache, vomiting, abdominal pain, and vision disturbances can be observed.
Leukemia diagnosis is made through examinations and detailed tests performed by specialist pediatric hematologists. Findings such as liver and spleen enlargement, swollen lymph nodes, and bleeding may be notable during examinations. Blood tests, bone marrow biopsy, and genetic tests are used to determine the type and stage of the disease. These tests aid in defining an appropriate treatment plan.
Treatment
The treatment of leukemia begins with supportive therapies aimed at improving the child's overall condition. Patients with low blood values are given blood or blood cells from donors, treatments are applied in case of infection, and precautions are taken to protect the kidneys, liver, and heart from potential side effects of chemotherapy drugs.
An essential step in treatment is the information provided to families. During this process, families are informed that leukemia is a treatable disease, where with moral support, treatment success can reach up to 85%. Leukemia treatment is carried out over a period of about 4-6 weeks using high doses and different types of chemotherapy drugs. The goal is to destroy immature blood cells called blasts.
Chemotherapy drugs affect not only malignant cells but also the body's beneficial cells. This condition can lead to side effects such as hair loss, mouth and intestinal sores, and fatigue. Due to weakened immune systems, children with leukemia continue their lives wearing masks to protect against infections. In today's medical landscape, leukemia is highly treatable, thanks to advancing medical capabilities. With early diagnosis and appropriate treatment, success can be achieved in the fight against leukemia. It is crucial to correctly inform and support the families of patients, as well as the patients themselves, during the leukemia treatment process.
Why is Psychological Support Important for Children with Leukemia?
Leukemia is a disease that affects not only the physical but also the psychological aspects of children and their families profoundly. Long treatment processes, time spent in the hospital, changes in outward appearance such as hair loss, and being distanced from social life can lead to emotional responses such as anxiety, fear, anger, and depression in children. In this process, monitoring the child's psychological state, providing opportunities for them to express their feelings, and supporting them appropriately is critically important.
Psychological support for children with leukemia enhances motivation and facilitates treatment compliance. Approaches like play therapy, art therapy, and group therapies can help externalize the emotional challenges the child is experiencing and assist in navigating this process more healthily. It is also very important for families to receive psychological support for their own wellbeing and to communicate effectively with their child. It must be remembered that morale is a significant factor affecting success in leukemia treatment.
What Should the Follow-Up Process After Leukemia Be Like?
Successfully completing leukemia treatment does not indicate that the patient is completely cured. The monitoring period that begins after the treatment process is of critical importance to reduce the risk of relapse (recurrence of the disease) and to detect possible complications early. Therefore, regular doctor consultations, blood tests, and imaging examinations, when necessary, should not be neglected.
Particularly during the first 1-2 years after leukemia, much tighter monitoring is conducted. During this time, since the child's immune system has not yet fully recovered, it is important to protect against infections. Attention should be paid to dietary habits, sleep routines, and hygiene rules. Additionally, returning to school life should be phased and conducted with a doctor's approval. Awareness of relapse symptoms by families provides an advantage for early intervention. The follow-up process involves monitoring not only the disease but also the child's physical, mental, and social development.
The Role of Families in Leukemia and the Importance of an Informed Approach
The attitude of the family during the leukemia treatment process has a direct effect on the child's psychological state and compliance with the treatment. Families should be well-informed about the disease, understand that the process is temporary and can result in a high success rate, and convey this to the child. Providing age-appropriate, clear, and honest answers to a child's questions helps them feel safe.
To prevent the child from feeling worthless or different, families should avoid overprotectiveness in relationships and adopt a balanced approach. Not isolating the child completely from school, friends, or social environments helps to strengthen them psychologically. Participation in support groups organized for families can be beneficial both for sharing experiences and gaining information. A conscious, patient, and loving approach is the child's greatest strength in the fight against leukemia.
Frequently Asked Questions
What Is Bone Marrow Aspiration and Biopsy?
Bone marrow aspiration and biopsy are two procedures critically important in diagnosing leukemia and monitoring the treatment process. Bone marrow aspiration aims to obtain a liquid sample from the bone marrow, while a biopsy aims to obtain a solid tissue sample. These procedures are typically performed from the back of the pelvis and are conducted under local anesthesia or sedation. Post-procedure, the samples are examined in a laboratory to provide information about the presence and type of leukemia cells.
Leukemia Is the Most Common Cancer Type in Children
Leukemia is the most commonly encountered cancer type during childhood. Approximately 1,200-1,500 children are diagnosed with leukemia every year in Turkey. The most common type is Acute Lymphoblastic Leukemia (ALL), usually seen in children aged 2-5. Although the exact cause of leukemia is unknown, genetic factors, radiation, certain chemicals, and viral infections are considered risk factors.
What Are the Symptoms of Leukemia in Children?
Recognizing the symptoms of leukemia in children plays a crucial role in early diagnosis. Common symptoms include:
-
Persistent fatigue and weakness
-
Pale skin
-
Frequent infections
-
Nose and gum bleeding
-
Easy bruising on the body
-
Bone and joint pain
-
Abdominal swelling
-
Loss of appetite and weight loss
-
Night sweats and fever
As these symptoms may indicate leukemia, it is important to consult a specialist without delay.
How Is Leukemia Diagnosed in Children?
Leukemia is diagnosed through physical examination and various laboratory tests. Initially, a complete blood count test is conducted to detect abnormal white blood cell counts. Subsequently, bone marrow aspiration and biopsy are performed to determine the presence and type of leukemia cells. Additionally, genetic tests and imaging methods may be used during the diagnostic process.
How Is Leukemia Treated in Children?
The treatment of leukemia in children varies based on the type and stage of the disease. The most common treatment methods are:
-
Chemotherapy: This drug treatment is used to destroy leukemia cells. It is generally applied in several stages, and the treatment process can last 2-3 years.
-
Radiotherapy: Primarily used in cases with central nervous system involvement.
-
Bone Marrow Transplant: Preferable in high-risk or treatment-resistant cases. Healthy stem cells from a suitable donor are transplanted to the patient.
-
Supportive Treatments: Include measures such as infection prevention, nutritional support, and psychological support.
How Long Does Bone Marrow Aspiration and Biopsy Take?
The bone marrow aspiration and biopsy procedure typically takes between 15-30 minutes. Local anesthesia or sedation is administered to the patient before the procedure. Samples collected after the procedure are examined in a laboratory, and results are usually available within a few days.
In Which Age Range Is Leukemia Most Commonly Seen in Children?
Leukemia is most commonly seen in children between the ages of 2-5, though it can occur in any age group. Particularly in children under 1 year and over 10 years, leukemia may progress more aggressively, and response to treatment might be more challenging. Hence, early diagnosis and treatment upon noticing symptoms are of paramount importance.
What Are the Symptoms of Leukemia in Children?
As previously mentioned, symptoms of leukemia in children include fatigue, pale skin, frequent infections, nose and gum bleeding, bruising, bone and joint pain, abdominal swelling, loss of appetite, weight loss, night sweats, and fever. As these may indicate leukemia, it is important to consult a specialist without delay.
How Long Does Leukemia Treatment Last in Children?
The duration of leukemia treatment in children varies based on the type and stage of the disease. Generally, the treatment process can last 2-3 years. During this period, chemotherapy is the main treatment method, and in some cases, radiotherapy and bone marrow transplantation may be applied. Regular check-ups and tests are conducted throughout the treatment duration.
What Should Be Considered After Bone Marrow Aspiration and Biopsy?
After the procedure, the biopsy area should be kept clean and dry. Bathing should be avoided, and heavy physical activities should be refrained from for the first 24 hours. If symptoms such as pain, swelling, or redness are observed in the procedure area, it is crucial to consult a doctor immediately.