White Blood

“You can’t pick up the telephone and say, ‘Connect me with someone else who has a kid with leukemia’.”- Howard Rheingold

The term leukemia comes from the Greek words for White and Blood.  It is a cancer of the blood that starts in the bone marrow and spreads to the bloodstream when one white blood cell mutates and begins to multiply uncontrollably. That one cell become 10 billion cells in a short amount of time.

Most symptoms of leukemia can be attributed to other common childhood illness like a cold of flu.  Tucker’s leukemia presented itself with vomiting, fatigue and anemia.  Joint or bone pain, fevers, bruising or bleeding can be other symptoms.

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer (35% of all cancers in children). There are about 7,000 new cases in children and adolescents each year in the United States.  ALL can affect either the B-cell or T-cell.  Most children with ALL are cured of their disease after treatment.

Acute myeloid leukemia (AML) is more common in adults, however approximately 500 new cases of AML are diagnosed in children each year in the United States. AML has 8 different sub-types. Treatment will vary based on the sub-type.  AML can invade the lymph nodes, brain, skin, liver, kidney, ovaries, testes, and other organs. Sometime it forms a solid tumor called a “chloroma.”  About 4 out of 5 children with AML go into remission with half of them having no signs of disease after five years which is considered cured.

Chromosome changes in leukemia cells can affect the treatment of either type of leukemia. My son has a translocation of the 17 & 19 chromosomes t(17:19). Translocation means they have switched places. It causes the cancer to be more resistant to treatment.  PH-positive ALL is a translocation of the 9 & 22 chromosomes t(9;22) Both types are difficult cancers cure.

(Tucker sleeping after his first consolidation treatment)

Leukemia is treated with an induction period designed to destroy as many leukemia cells in the body as possible in a 28 day cycle.  The goal is to get below 5% of leukemia cells in the bone marrow which is considered remission.  Consolidation treatment are done next to kill off the remaining cells and get the patient to show no evidence of leukemia cells in the bone marrow. (Tucker is at this point now!)  Maintenance treatment is about 1.5 years in girls and 2.5 years in boys. A monthly dose of chemotherapy is given to encourage the patient to remain in remission.  Spinal taps are done regularly during treatment to put chemotherapy in the spinal fluid to treat and prevent leukemia cells that could be found in the lining of the spinal cord and brain.  Stem cell transplants are done to start an new supply of blood cells after a large dose of chemotherapy or radiation therapy that is used to kill the leukemia cells but also kills the healthy stem cells in the bone marrow.  Stem cell transplants are not a guaranteed cure but can often help the patient to remain in remission.

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