In 2007, in the United States, approximately 10,400 children younger than 15 years of age were diagnosed with cancer, and leukemia accounted for approximately one-third of these childhood cancer cases (American Cancer Society 2007; Ries et al., 2008). The diagnostic groups and specific diagnoses of pediatric leukemia are outlined in Table 22.1. These percentages are determined from data collected from the Surveillance, Epidemiology, and End Results 2001–2005 Program of the National Cancer Institute (Ries et al., 2008).
Common Types of Pediatric Leukemia
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Common Types of Pediatric Leukemia
|Lymphocytic Leukemia ||Myeloid and Nonlyphocytic Leukemia |
Accounts for 79% of all childhood leukemia cases
Acute lymphoblastic leukemia accounts for 99% of the lymphocytic leukemias
Chronic lymphocytic leukemia accounts for <1% of the lymphocytic leukemias
Nearly 80% survival rate for children with acute lymphoblastic leukemia older than 1 year and younger than 10 years of age. Infant and adolescent survival rates are not as favorable.
Accounts for 18% of all childhood leukemia cases
Acute myeloid leukemia accounts for 76% of the nonlymphocytic leukemias
Acute monocytic leukemia accounts for 11% of the nonlymphocytic leukemias
Chronic myeloid leukemia accounts for 10% of the nonlymphocytic leukemias
Approximately 40% survival rate for acute myeloid leukemia
Medical intervention for children with leukemia varies according to the type of leukemia and the protocol. Each medical institution uses specific protocols to guide the drugs and dosages that children will receive. All children with leukemia receive chemotherapy and in some cases radiation. If a child with acute lymphoblastic leukemia (ALL) has a relapse, meaning that the cancer has returned, a stem cell transplant (SCT) or bone marrow transplant (BMT) is typically administered. Children with acute myeloid leukemia (AML) often receive chemotherapy for a few months and then receive a BMT or SCT. SCT includes only the most immature type of cell, given before the cell has differentiated to a specific type. BMT involves administering marrow, including all types of cells. The protocols for children with leukemia commonly include some or all of the following phases:
Induction, which lasts approximately 4 to 6 weeks. High doses of a combination of chemotherapy agents are given to eliminate the leukemia cells, with the goal of achieving remission.
The consolidation and intensification phases, which last 1 to 2 months. High doses of chemotherapy are given to eliminate any remaining cancerous cells.
Maintenance therapy, which for children with ALL lasts approximately 2 calendar years for girls and 3 calendar years for boys. Low doses of chemotherapy are given with the goal of preventing relapse. In the future boys may begin to participate in protocols ...
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