DESCRIPTIONAcute leukemia is a malignant overgrowth of white blood cells in bone marrow or tissues that are part of the lymphatic system (lymph glands, spleen, liver). These excess cells accumulate and spill into the bloodstream, eventually involving other tissues. Common forms of leukemia include acute lymphocytic leukemia (especially prevalent in children), acute myelogenous leukemia, and acute monocytic leukemia. Acute leukemia is the most common form of cancer in children. The bone marrow and lymph tissue are involved in the early stages. The disease eventually affects all body tissues. Acute leukemia can affect both sexes, all ages, but is more common in males. Acute lymphocytic leukemia has a peak incidence between ages 2 and 5.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Home care after diagnosis and treatment and during remission.
Hospitalization for treatment in the initial stage or for relapse.
SIGNS & SYMPTOMSLow fever.
General ill feeling.
Easy bruising and spontaneous bleeding (nosebleeds, bleeding from the gums, or prolonged menstruation).
Enlarged spleen and abdominal pain.
Susceptibility to infection, especially pneumonia.
Mouth infections with ulcers and sores.
Headache and lethargy, if your child's meninges (brain membranes) are affected.
Unknown, but there are many suspected predisposing factors -- especially viruses and radiation.
RISK FACTORSFamily history of leukemia.
Excess exposure to X-rays.
Congenital disorders, especially Down syndrome.
Being identical twins.
Exposure to benzenes, which are used in many industrial chemicals.
Use of cytotoxic drugs.
PREVENTING COMPLICATIONS OR RECURRENCECannot be prevented. If you have a family history of leukemia, obtain genetic counseling before starting a family.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies of the child's blood, bone marrow, and cerebrospinal fluid.
Death from destruction of the body's defenses against infection.
Treatment brings remission in 90% of children and cure in 50% for some forms of leukemia. Other forms are eventually fatal.
A child with leukemia should avoid ill persons and crowds to prevent dangerous exposure to infection.
The child should rinse the mouth often with a warm salt-water solution to decrease mouth ulcers. Use 1 tablespoon salt in 8 oz. water.
Encourage your child to use a soft toothbrush to prevent gum abrasion.
Your doctor may prescribe anti-cancer drugs; cortisone drugs; pain relievers; antibiotics to fight infection; uricosuric drugs to increase excretion of uric acid that may accumulate as a side effect of anti-cancer drugs.
No restrictions for your child during remissions. Bed rest is usually necessary during active phases of the disease.
DIET & FLUIDS
Encourage your child to drink extra fluids. Older children and adults should drink 8 to 10 glasses of fluid daily, and younger children should drink 4 to 6 glasses of fluid. During chemotherapy, urge your child to eat and drink high-calorie foods and beverages, such as milkshakes or eggnog.
OK TO GO TO SCHOOL?Yes, during remission or when appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of leukemia.
The following occurs during active stages or remissions:
-- Fever, chills, cough, or sore throat.
-- Abnormal bleeding. Apply pressure and ice while awaiting your doctor's return call.