Leukaemia in Children: What Parents Should Know

Leukaemia is the most common cancer in children. Hearing that your child may have leukaemia is every parent's worst fear. But with early detection and proper treatment, many children with leukaemia in Pakistan can be successfully treated.

What is leukaemia? Leukaemia is a cancer of the blood. It starts in the bone marrow — the spongy tissue inside bones where blood cells are made. In leukaemia, the body produces abnormal white blood cells that do not work properly. These abnormal cells multiply quickly and crowd out healthy blood cells.

Why does leukaemia affect children? Most childhood leukaemias are acute, meaning they develop rapidly. The exact cause is often unknown. It is NOT caused by anything the parents did or did not do. You cannot catch leukaemia from someone else.

Types of childhood leukaemia:

• Acute Lymphoblastic Leukaemia (ALL): The most common type in children. About 75% of childhood leukaemias are ALL. It is highly treatable.
• Acute Myeloid Leukaemia (AML): Less common but also treatable with aggressive chemotherapy.

Warning signs in children: Parents should watch for these symptoms, which often appear over days or weeks:

• Pale skin — looking unusually pale or washed out
• Unexplained fever — lasting more than a few days
• Frequent infections — one infection after another
• Easy bruising or bleeding — bruises without injury, nosebleeds, bleeding gums
• Bone or joint pain — child limping or refusing to walk
• Swollen lymph nodes — lumps in the neck, armpits, or groin
• Tiredness and weakness — less active than usual
• Unexplained weight loss
• Abdominal swelling — enlarged liver or spleen

Important: These symptoms can also be caused by common childhood illnesses. But if they persist or several appear together, your child MUST see a doctor.

What should parents do? If you notice any of these signs, take your child to a doctor immediately. A simple blood test (CBC) can often detect leukaemia. If the blood test is abnormal, the doctor will refer your child to a specialist.

Diagnosis:

• Blood tests (CBC, peripheral smear)
• Bone marrow aspiration and biopsy
• Further tests to determine the type and stage

Treatment in Pakistan: Leukaemia treatment is available at:

• Shaukat Khanum Memorial Cancer Hospital (Lahore, Peshawar, Karachi)
• Aga Khan University Hospital (Karachi)
• The Children's Hospital (Lahore)
• NIBD (Karachi)
• AFBMTC (Rawalpindi)
• Pathwell Hospital (Rawalpindi)
• Shifa International Hospital (Islamabad)

Treatment usually involves:

• Chemotherapy — the main treatment, given in phases over 2-3 years
• Supportive care — blood transfusions, antibiotics
• In some cases, bone marrow transplant
• Tyrosine kinase inhibitors
• Antibody-drug conjugates
• Cellular therapies

Survival rates: With proper treatment, childhood ALL has a survival rate of over 85% in developed countries. In Pakistan, outcomes are improving but delayed diagnosis remains the biggest challenge. The earlier the diagnosis, the better the chance of cure.

Common myths in Pakistan:

• "Leukaemia is a death sentence." — False. Many children are cured with treatment.
• "Blood transfusions cause cancer." — False. Transfusions save lives during treatment.
• "Traditional medicine can cure leukaemia." — False. Only chemotherapy can treat leukaemia. Delaying treatment for traditional remedies is dangerous.
• "Leukaemia is inherited from parents." — False. It is not necessarily passed down from parents. It can also be genetic.

Key message: Leukaemia is the most common cancer in children, but it is treatable. Watch for pale skin, fever, bruising, and bone pain. A simple blood test can detect it. Do not delay — early diagnosis saves children's lives.