Acute Leukemias In Children

Introduction: This is the commonest cancer in children. Types of leukemia seen in pediatric age group are
1. Acute lymphoblastic leukemia
2. Acute non-lymphoblastic leukemia
3. Chronic myeloid leukemia

Acute lymphoblastic leukemia:
Incidence: ALL is the most common type of leukemia in children.The incidence of ALL is about 30 cases per million people per year. The peak age of developing ALL is 2-6 years.

Etiology:
1. Genetic factor- It is seen in identical twins, Fanconi's anamia, Down's & Klinefelter's syndrome,
2. Immunologic factor- Ataxia telangiectasia
3. Environmental factor-Exposure to radiation, chemotherapeutic agents like alkalyting agents.
4. Viral infection- Epstein-Barr virus

Clinical features:
1. Anemia (fatigue, irritability, pallor)
2. Thrombocytopenia (bleeding, petechiae)
3. Neutropenia (fever)
4. Lymphadenopathy
5. Hepatospenomegaly
6. Joint pains
7. Headache, vomitings (Brain involvement)

Diagnosis:
1, Complete blood count-Eleveted leucocyte counts
2. Serum levels of uric acid, potassium, phosphorus, and calcium, and lactate dehydrogenase
3. Bone marrow aspiration & biopsy: The presence of 30% or more blasts in marrow is s/o acute leukemia
4. Lumbar puncture
5. Cytological & Molecular diagnosis
6. Ultrasonography: testis, kidneys
7. Chest X-ray

Chemotherapy: is the mainstay of treatment
Induction, CNS prophylaxis, consolidation & Maintenance therapy

Surgical role: Central line insertion for chemotherapy