Leukemia cells are abnormal cells that cannot do what normal blood cells do. The abnormal cells are immature white blood cells that cannot help the body fight infections. For this reason, children with ALL often get infections and have fevers.
ike all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, patients with leukemia may have a number of symptoms. Children with ALL frequently have low amounts of healthy red blood cells and platelets. As a result, there are not enough red blood cells to carry oxygen through the body. With this condition, called anemia, patients may look pale and feel weak and tired. When there are not enough platelets, patients bleed and bruise easily
Some of the common symptoms of ALL include
• Fever
Fatigue
• Frequent infections;
• Swollen or tender lymph nodes, liver, or spleen;
• Bone or joint pain.
• Easy bleeding or bruising;
1Dignose
f a child has symptoms that suggest leukemia, the physician may first order blood tests. A sample of blood is examined to determine the number of normal blood cells, to see what the cells look like, and to find out if any leukemia cells are present in the blood. For a definitive diagnosis of ALL, a doctor who specializes in leukemia examines a sample of bone marrow under a microscope. The sample is obtained by a procedure called bone marrow aspiration. In this procedure, the doctor inserts a needle into a large bone, usually the hip, and removes a small amount of liquid bone marrow for examination.
If leukemia cells are found in the bone marrow sample, the patient's doctor orders other tests to find out the extent of the disease. For example, a spinal tap, which is also called a lumbar puncture, checks for leukemia cells in the cerebrospinal fluid-the fluid that fills the spaces in and around the brain and spinal cord.
Types
Although leukemia cells from different children with ALL often look very similar under the microscope, there are actually many distinctive subtypes of ALL. Most cases of leukemia are associated with changes in genes and chromosomes in the cancerous white blood cells. The various subtypes of ALL can be identified using special laboratory tests that look for specific changes in genes and chromosomes. It is increasingly important for doctors treating children with ALL to determine their patients' subtype of ALL, as some treatments work better for some subtypes than for others.
Fector
The chance of survival for children with ALL is dependent upon a number of factors. The most important factor is receiving optimal care at a center experienced in the treatment of children with ALL. Even with optimal care, some children with ALL are much more difficult to treat successfully than others.
In the past, factors such as age and white blood cell count at diagnosis were commonly used to predict outcome. For example, children 1 to 9 years old have higher survival rates than do infants or older children. However, factors such as age and white blood cell count at diagnosis are, at best, crude predictors of outcome.
It is now clear that the patient's subtype of ALL has a powerful impact on survival. For example, infants commonly have a subtype of ALL in which a specific gene is modified. This subtype of ALL is very hard to treat successfully and only a minority of infants with this subtype of ALL survive with current therapy. Other subtypes of ALL in which different genes are modified occur more commonly in older children and have a much more favorable outcome.
It is now common practice for the leukemia cells of children with ALL to be tested for the gene modifications. The type of treatment is then based on the particular change seen in the leukemia cells
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