Childhood Leukemia in Latin America: Diagnosis and Treatment

How do doctors diagnose leukemia in children?

To diagnose leukemia, the doctor will ask questions about your child’s symptoms and do a physical exam. They may also recommend blood tests to check the levels of different red and white blood cells. If the results of the blood test are unusual, the doctor may refer your child to a hematologist or oncologist (cancer doctor).

If your child is referred to a pediatric cancer doctor, this doctor may do one or more of the following tests to diagnose leukemia:

• Bone marrow aspiration is when a doctor uses a special needle to take a small sample of liquid bone marrow from inside of the hip bone Your child will be sleeping safely and comfortably under general anesthesia for this test.
• Bone marrow biopsy is when a doctor uses a special needle to take a small sample of bone marrow from your child’s hip bone. Your child will be sleeping safely and comfortably under general anesthesia for this test. The liquid bone marrow and bone marrow biopsy specimens (samples) are processed in a hematology lab and by a pathologist (doctor who studies bodily fluids and tissues) to look for leukemia cells.
• Special lab tests of the blood and bone marrow samples help doctors figure out the type of leukemia.
• X-rays may be needed to help evaluate your child. There are many different types of X-ray machines, including CT and MRI scans
• Ultrasounds use soundwaves to create images of different parts of the body.
• Lymph node biopsy is when a doctor uses a small needle to take a sample of a lymph node (structures throughout the body that contain cells that help fight infection and illness). The biopsy sample is taken to a pathology lab for processing to check for cancer cells.
• Lumbar puncture is when a doctor places a very thin needle into your child’s spinal canal (the area that surrounds the spinal cord, a cord of nerves that runs through the spine). The doctor removes a small sample of spinal fluid (fluid that surrounds the spinal cord) and checks it under a microscope for cancer cells.

How do doctors treat leukemia in children?

Treatment depends on the type of leukemia your child has. Treatment is essential to your child’s wellbeing and survival. With treatment, about 6 of every 10 children (57.5%) with leukemia in Mexico survive.^v

Your child may receive one or more of the following treatments:

• Chemotherapy is the main type of treatment for leukemia. Chemotherapy can be given as a pill, an injection into the muscle or through an IV into a vein or the spinal canal. Children typically receive chemotherapy in cycles. This allows your child to rest and recover between doses.
• Chemotherapy with a stem cell transplant allows your child to receive higher doses of chemotherapy while their body rebuilds new bone marrow. For this treatment, your child will receive high doses of chemotherapy with or without radiation therapy. Then, they will receive stem cells through an IV. The chemotherapy and radiation are given to destroy the unhealthy bone marrow. Bone marrow stem cells are cells that can develop into different types of blood cells and help rebuild a normal bone marrow.
• Radiation therapy is a treatment that uses high-energy X-rays to kill cancer cells or stop them from growing.
• Immunotherapy helps your child’s immune system destroy cancer cells.
• Targeted therapies are medications that work against a specific genetic change in a cancer cell. Your child may receive targeted therapy in addition to chemotherapy, depending upon their exact type of leukemia.
• Clinical trials are research studies run by doctors and researchers to test new treatments. Ask your child’s care team if you would like to know about current or upcoming clinical trials.
• Supportive care is the term used to prevent or minimize side effects from treatments. Many cancer treatments can have side effects, such as pain, fever, infection, nausea or vomiting. Supportive care helps make these side effects more manageable.

Sources:
^vNational Registry of Cancer in Children and Adolescents (RCNA)

Rev. 1/2021. Rev. 1/2021. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.