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  • 1. Brooks 1Savannah BrooksMrs. CorbettAP Literature/ Composition17 November 2011 Pediatric Leukemia Since its discovery and diagnosis centuries ago, cancer has been an ever-present reminderof the brevity of life. Cancer can affect anyone; it does not discriminate against race, sex, or age,meaning even young children can be inflicted with this insidious disease. These pediatriconcology patients most commonly battle the blood cancer, leukemia, and though the prognosis isgrim, current research efforts have brightened the outlook. Sadly, leukemia and other types of cancer are daunting ubiquities in today’s society. Infact, they account for the “second leading cause of death after accidents in children from agesone to fourteen” (“Childhood Leukemia”). Though contracting this disease is atypical, it stillranks as a prevalent impetus in childhood mortality. This highlights the frightening notion that apossible hazard to children’s well-being lies outside the control of their parents. “Leukemia is themost frequent diagnosis for pediatric patients, accounting for about 1 out of 3 cancers inchildren” (“Childhood Leukemia”). This is a progressive, degenerative disease that spreadsthroughout the body. It entails the metastasis of cancerous cells through blood streams. It impactsvirtually every aspect of a child’s life. Affected children can show signs of weakness, fatigue, and extreme nausea almost atonset. “Leukemia is a form of cancer in which the body creates abnormal, malignant white bloodcells” (“Leukemias, Chronic”). Infected blood cells reproduce uncontrollably and can no longerregulate apoptosis, or programmed cellular death. This disease proves detrimental to a patient’s
  • 2. Brooks 2health as leukocytes are essential to the normal functioning of the body’s immune system.“Abnormal white blood cells develop from stem cells in the patient’s bone marrow” (“What isLeukemia?”). Once these cells have developed, they disperse through blood vessels and circulatethroughout the body’s circulatory and cardiovascular systems. As their numbers grow, thesecancerous leukocytes begin crowding the healthy white blood cells, red blood cells, and platelets,leading to difficulties in normal functioning. This phenomenon wreaks havoc on the small bodiesof pediatric patients. Oncologists categorize leukemia into two types based on the speed of progression.Included in this are chronic leukemia and acute leukemia. “Chronic leukemia develops slowly,deriving from abnormalities in mature blood cells” (“Differences Between Acute and ChronicLeukemia”). In its early stages, white blood cells can still function somewhat normally, thoughmuch less productively. As the disease progresses, these atypical leukocytes begin crowdingblood vessels, gradually hindering the production of healthy blood cells. Due to its slowadvancement, patients often times will show no symptoms until the later phases of the disease.“Acute leukemia, however, differs greatly from the former as this type develops and growsrapidly” (“Leukemias, Acute”). This kind results from abnormalities in undeveloped blood cells,preventing normal functioning. These leukemia cells multiply quickly and the disease worsensrapidly. Prognosis is usually determined earlier than in the initial stages of chronic leukemia andimmediate action is necessary. Furthermore, these broad categories are commonly dissected into four sub-genres upondiagnosis. “This includes acute lymphocytic leukemia (ALL), acute myelogenous leukemia(AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML)”(“Leukemia (cont.)”). Chronic lymphocytic leukemia affects lymph cells. Here lymphocyte B
  • 3. Brooks 3cells, which produce antibodies to signal the destruction of bacteria and viruses, and lymphocyteT cells, which recognize the signals of the antibodies and produce chemicals to destroy theinfiltrators, live much longer than normal cells and, therefore, begin to multiply, crowding theother blood cells. This disease progresses slowly and is most commonly seen in adultpopulations. Chronic myeloid leukemia is the uncontrolled growth of granulocytes, a type ofleukocyte and is usually uncommon in children. The bone marrow gradually produces too manyof these cells which then ground the vessels and hinder the cells’ normal ability to fightinfections. This disease is directly linked to abnormalities in genes. Most patients diagnosed withthis disease also have a chromosomal rearrangement where chromosome nine and twenty twobecome attached and exchange genetic material. This results in the inability to control cellulargrowth in the affected person. The typical forms of leukemia seen in adolescents and children arethe acute diseases. One of the most serious types is acute myelogenous leukemia. This too resultsfrom the overproduction of granulocytes; however, since it is acute, these cells cannot maturecorrectly. AML rapidly causes cellular overcrowding. Children with genetic disorders, such asDown syndrome, have a higher risk for developing this kind. Acute lymphocytic leukemia,singly, accounts for the highest number of childhood leukemias. This is similar to chroniclymphocytic leukemia in that it too affects lymphocyte cells; however, it overproduces cellswhich cannot mature properly as opposed to older cells as in CLL. This prevents blood cellsfrom working properly to ward off infection and can spread throughout the body in a matter ofweeks. Chromosomal abnormalities are a commonality among patients with this disease as well. Though leukemia is an internal disease, physical signs and symptoms indicate theexistence of problems harbored beneath the surface. “These signals include anemia, frequenthemorrhages, easy bruising, chronic infections, abdominal pains, dyspnea, bone and joint pain,
  • 4. Brooks 4and swollen lymph nodes” (“Leukemia”). Early signs of leukemia include anemia, excessivebleeding, and easy bruising because increased quantities of white blood cells cause crowding inthe bone marrow, where blood cells are produced, hindering the production of adequate amountsof red blood cells, leading to anemia, and platelets, causing excessive bleeding and bruising.Recurrent infections are also commonly associated with leukemia because although white bloodcell counts are abnormally high, these blood cells themselves are atypical and, therefore, do notfunction properly in fighting viral or bacterial contaminants. Abdominal pains, inflamed lymphnodes, and labored breathing as leukocytes can collect in the abdomen, causing swelling thekidney, liver, and spleen, and in lymph nodes and the thymus causing swelling and difficultybreathing, respectively. Though these signs and symptoms indicate the presence of leukemia, theformal diagnosis of this disease occurs following medical tests. “These diagnostic proceduresinclude bone marrow biopsies, lymph node biopsies, lumbar punctures, and blood tests”(“Leukemia”). With both bone marrow and lymph node biopsies, a small portion of matter isremoved from the specified area. These extractions are then examined, looking for anyabnormalities in cell growth and quantity. Spinal fluid is removed in a lumbar puncture andtested to determine the patient’s underlying problems. Also, simple blood work is an adequatedeterminant of the illness. In these tests, the patient’s blood is drawn so doctors can evaluate thecellular makeup of the fluid and any possible irregularities. Such evaluations begin the process of designing a plan for therapy. Treatments varybased on the type of leukemia, its stage upon diagnosis, and the patient’s age. “Commontreatments for leukemia include chemotherapy, bone marrow transplant, and radiation therapy”(“Leukemia Diagnosis”). The first treatment method calls for patients to ingest or inject strongdrug cocktails into their bodies, killing the cancerous blood cells that have spread throughout
  • 5. Brooks 5their blood systems. This is the most effective form of treatment for leukemia and a doctor’susual preference when treating this disease. Radiation therapy is also sometimes utilized intreatment plans. Most often this is effective in destroying cancerous cells that have accumulatedin an area of the body. Here oncologists use energized beams and rays, damaging leukemia cellsand hindering their continued growth. Bone marrow transplants are usually the final stage oftreatment, following rounds of chemotherapy or radiation therapy. After a patient is matchedwith a donor, doctors replace his diseased bone marrow without that of healthy donor marrow.With this, the body will begin to produce normal blood cells. Recently the growing field ofbiomedical engineering has enabled alternative treatment plans for leukemia. “Such innovativetechniques comprise of biological therapy and targeted therapy” (“Treatments and Drugs”).Biological therapy utilizes a patient’s own immune system, aiding in the recognition, flagging,and destruction of cancerous cells. The latter novel treatment entails the utilization of drugsdesigned only to target weaknesses in the cancer cells, leaving normal functioning cellsunharmed. These drugs could range from protein inhibitors to apoptosis-inducing medications.Such attempts are, at best, beneficial, but rarely lead to long-term success. Unfortunately there is no cure for cancer. Though many effective treatments do exist, thisdoes not guarantee that they can rid the body entirely of cancer or prevent it from coming back inthe future. “After treatment begins, the primary goal is to be able to say the affected child is inremission” (Miller). A patient in remission no longer shows evidence of cancerous cells in hisbody. This means that they no longer must go through the intensive chemotherapy and radiationtreatments before which caused hair loss and severe nausea. However, since cancer is notcompletely remediable, maintenance chemotherapy is often suggested. This is administered insmall cycles over a few years in the hopes of preventing the recurrence of the disease. In spite of
  • 6. Brooks 6these precautions, sometimes the cancer will return and further measures must be taken to onceagain battle the disease. Though this gloomy cloud still lurks overhead, the outlook for mostpediatric oncology patients is relatively bright. “Some forms of leukemia have a remission rateof up to 90%” (Miller). This extraordinarily high success rate is a direct indication of hisresponse to treatment, overall health, and genetics. If the cancer is caught in its early stages andthe child receives proper medical care, he can most likely go on to live a long, joyous life. Whilethis disease should not be taken lightly, diagnosis is not a death sentence. Cancer touches everyone’s lives in some fashion. It is destructive and unforgiving,shattering families and stealing away loved ones. Pediatric cancer, especially the diabolicleukemia, is a particularly troublesome conundrum for modern medicine. Yet as advancements inprescription therapies progress, virulent fundraising continues, and brave children continue tofight, the odds are improving. One day, this sinister disease will be a distant memory.
  • 7. Brooks 7 Works CitedCherath, Lata. “Leukemias, Acute.” The Gale Encyclopedia of Medicine. Ed. Deirdre S. Blanchfield and Jacqueline L. Longe. 2nd ed. Vol. 3. Detroit: Gale, 2002. 1986-90. Gale Virtual Reference Library. Web. 1 Nov. 2011.- - -. “Leukemias, Chronic.” The Gale Encyclopedia of Mediciine. Ed. Deirdre S. Blanchfield and Jacqueline L. Longe. 2nd ed. Vol. 3. Detroit: Gale, 2002. 1990-93. Gale Virtual Reference Library. Web. 5 Nov. 2011.“Childhood Leukemia.” American Cancer Society. American Cancer Society, Inc., 2011. Web. 21 June 2011. <http://www.cancer.org/Cancer/LeukemiainChildren/DetailedGuide/childhood-leukemia- key-statistics>.“Difference Between Acute and Chronic Leukemia.” DifferenceBetween.net. N.p., 2011. Web. 6 Nov. 2011. <http://www.differencebetween.net/science/health/difference-between-acute-and- chronic-leukemia/>.“Leukemia.” Pediatric Leukemia. Lucile Packard Children’s Hospital, 2011. Web. 1 Nov. 2011. <http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/oncology/leukemia.html>.“Leukemia (cont.).” MedicineNet.com. MedicineNet, Inc., 2011. Web. 9 Nov. 2011. <http://www.medicinenet.com/leukemia/page3.htm>.“Leukemia Diagnosis.” Cancer Treatment Centers of America. N.p., n.d. Web. 4 Nov. 2011. <http://www.cancercenter.com/leukemia/leukemia-diagnosis.cfm>.Miller, Robin E. “Leukemia.” Children’s Healthcare of Atlanta. The Nemours Foundation/KidsHealth, 2010. Web. 2 Nov. 2011. <http://www.choa.org/child-health-glossary/l/le/leukemia>.“Treatments and Drugs.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 2011. Web. 8 Nov. 2011. <http://www.mayoclinic.com/health/leukemia/DS00351/ DSECTION=treatments-and-drugs>.
  • 8. Brooks 8“What Is Leukemia?” National Cancer Institute. N.p., n.d. Web. 2 Nov. 2011. <http://www.cancer.gov/ cancertopics/wyntk/leukemia/page2>.