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Leukemia may affect red blood cells, white blood cells, and platelets.

In a healthy child, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell.

A myeloid stem cell becomes one of three types of mature blood cells:

  • Red blood cells that carry oxygen and other substances to all tissues of the body.

  • Platelets that form blood clots to stop bleeding.

  • White blood cells that fight infection and disease.

A lymphoid stem cell becomes a lymphoblast cell and then one of three types of lymphocytes (white blood cells):

  • B lymphocytes that make antibodies to help fight infection.

  • T lymphocytes that help B lymphocytes make the antibodies that help fight infection.

  • Natural killer cells that attack cancer cells and viruses.

Acute Lymphoblastic Leukemia

In a child with ALL, too many stem cells become lymphoblasts, B lymphocytes, or T lymphocytes. These cells are cancer (leukemia) cells. The leukemia cells do not work like normal lymphocytes and are not able to fight infection very well. Also, as the number of leukemia cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may lead to infection, anemia, and easy bleeding.

 

DIAGNOSIS & TREATMENT

Part of the diagnosis involves numerous blood tests including full blood counts, blood chemistry tests, chest xrays, physical exams, cytogenetic analysis, immunophenotyping, lumbar punctures and barrow marrow aspiration and biposy. Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidi needle (a long, hollow needle) is inserted into the patient’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.

Lumbar puncture : A procedure used to collect a sample of cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. The sample of fluid is checked for leukemia cells. This procedure is also called an LP or spinal tap.Lumbar puncture. A patient lies in a curled position on a table. After a small area on the lower back is numbed, a spinal needle (a long, thin needle) is inserted into the lower part of the spinal column to remove cerebrospinal fluid (CSF, shown in blue). The fluid may be sent to a laboratory for testing. 

 

The treatment of standard-risk childhood acute lymphoblastic leukemia (ALL) during the remission induction, consolidation /intensification, and maintenance phases always includes combination chemotherapy. Children who are not in remission after having combination chemotherapy during the induction phase may be helped by more chemotherapy. When they are in remission, a stem cell transplant using stem cells from a donor may be done.

 

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