Leukemia in Children and Adolescents

At Rush Children’s Hospital, we believe in caring for the whole child — and their families — while treating leukemia and lymphoma.

Pediatric hematologist/oncologists, psychologists, palliative care specialists and other clinicians at Rush use the latest diagnostic, medical and surgical therapies to treat leukemia and lymphoma  in children. Your child’s entire care team — which also includes nurses, child life specialists, social workers and other staff — will help you and your child stay strong and resilient throughout treatment and recovery.

Remarkable Care for Kids

  • Multidisciplinary pediatric leukemia expertise: Pediatric hematologist/oncologists at Rush University Children’s Hospital specialize in leukemia and have years of experience diagnosing and treating children with this disease. They partner with a multidisciplinary team of pediatric experts to determine the most effective leukemia  treatment for your child.
  • Expert care for adolescents and young adults: Pediatric hematologists/oncologists at Rush collaborate with medical oncologists  to provide treatment with therapy protocols specifically designed for adolescents and young adults that have been shown to have superior cure rates for leukemia.  
  • Kid-friendly care: We know that kids don’t stop being kids when they develop bone cancer. Child life specialists at Rush will make sure that your child gets time to play, hang out, study and socialize — whether in their cheerfully-designed patient room or in our activity center and lounges filled with toys, books and games.
  • Access to clinical trials: As a member of the Children’s Oncology Group (COG), Rush offers our patients opportunities to enroll in national clinical trials of new treatments for leukemia in children, adolescents and young adults. 
  • Focus on quality of life: Pediatric psychologists and pediatric palliative care specialists offer an additional layer of care and support to your child as they undergo treatment for leukemia. Palliative care focuses on improving your child’s quality of life, managing pain and providing emotional support for your child and your family. Additionally, our social workers, cases managers and finance specialists are dedicated to supporting you and your family at every point in your child’s care and treatment.

What is leukemia in children?

Leukemia is the most common cancer in children. It begins in immature blood cells inside bone marrow, or the spongy inside of bones. When children develop leukemia, these blood cells do not develop normally. These abnormal — or cancerous — cells then start to multiply and spread through a child’s bloodstream. 

The disease often begins in a child’s white blood cells, which fight infection. But the cancer can also develop in the red blood cells that carry oxygen throughout the body. The platelets — which help blood clot — can also be affected.  

Children with certain inherited disorders or conditions, including Down syndrome and Li-Fraumeni syndrome, have a slightly higher risk of developing leukemia. So do children who take medications that suppress their immune system or who received chemotherapy or radiation therapy for cancers. However, most of the time, childhood leukemia has no known cause. 

Symptoms of leukemia in children

  • Unexplained fevers
  • Cuts that bleed for an unusually long time or frequent bloody noses and gums
  • Viral and bacterial illnesses that recur and happen more frequently than they have in the past
  • Anemia, which causes fatigue, dizziness, paleness, shortness of breath and easy bruising
  • Clusters of tiny red spots on your child’s body, which indicate bleeding under the skin 
  • Swollen glands, or lymph nodes, in the neck, groin or elsewhere
  • Severe tiredness 
  • No appetite
  • Achy joints
  • Coughing or trouble breathing

Many symptoms associated with leukemia in children can mimic those of other childhood health conditions. Your child’s pediatrician can help you determine whether you should consult with a specialists at Rush University Children’s Hospital.

Types of leukemia in children

Most children who have leukemia have a rapidly developing — or acute — form of the disease.

  • Acute lymphocytic leukemia (ALL): About three quarters of children with leukemia have ALL, which is a fast-growing cancer affecting the lymphocytes, a type of white blood cell.
  • Acute myelogenous leukemia (AML): AML develops in four different types of blood cells: myeloblasts, monoblasts, erythroblasts or megakaryoblasts. While it can develop at any age, AML tends to affect infants and toddlers, as well as teenagers. About one-fifth of children with leukemia have AML.

A small number of children with leukemia develop juvenile myelomonocytic leukemia. This rare disease disrupts the production of white blood cells. It tends to develop in children before they reach school age.

There are also slow-developing — or chronic — forms of leukemia, including chronic myelogenous leukemia. But chronic leukemia tends to affect adults and is rare in children. Some types of leukemia that develop in adults, particularly the chronic varieties, do not tend to develop in children.

Diagnosing leukemia in children

To determine or confirm that your child has leukemia, your child’s clinician will order the following tests:  

  • Blood test: Blood tests can determine if your child is having a problem with their blood, which can indicate leukemia.
  • Bone marrow aspiration and biopsy: After your child is sedated, a pediatric surgeon will insert thin needles into a bone to remove a sample of bone and bone marrow to test for leukemia.
  • Spinal tap: Also known as a lumbar puncture, this test is performed to determine if the leukemia has spread to the cerebrospinal fluid (CSF), which protects the brain and spinal cord. Your child will be sedated and then a thin needle will be used to obtain a CSF sample from the spine. 
  • Imaging tests: Your child may also get X-rays, MRIs and other imaging tests.

Categorizing leukemia in children

Part of the diagnosis process is determining the specific features of the leukemia your child has.

Some types of cancer are typically assigned a stage — for example, from I to IV — that indicates whether and how far the cancer has spread. But this type of staging does not apply to childhood leukemia. That’s because leukemia is in the bloodstream, and can easily spread around the body. 

Instead of giving your child’s leukemia a stage, the pediatric hematologist/oncologist may classify the disease in other ways, such as the type of cellular chromosomes involved or how the cells look under the microscope. These factors can help your child’s care team develop a personalized treatment plan specific to the type of leukemia. 

Treatment for leukemia in children at Rush

Thanks to treatment advances over the past two decades, the majority of children with leukemia can be cured.

At Rush University Children’s Hospital, our focus is on your child’s long-term health and development, in addition to treating the cancer. Your child’s care team is dedicated to developing a treatment plan for your child that fights the cancer with the fewest side effects as possible.

Children with leukemia benefit from the comprehensive expertise of a multidisciplinary team of clinical and supportive care specialists at Rush. Your child’s clinical team — comprised of physicians, registered nurses and clinical research associates — will meet regularly to design individualized treatment plans for your child.

Your child’s treatment may include some or all of the following:

  • Drug therapies:
    • Chemotherapy: Your child may receive chemotherapy to kill the cancer cells and prevent the cancer from spreading.
    • Targeted, or directed, therapy: After identifying molecular mutations in blood cancer cells, we can recommend drugs that specifically attack those mutations. These targeted drugs tend to cause fewer side effects than chemotherapy because they do not harm healthy, noncancerous cells.
    • Immunotherapy: Some types of immunotherapy, which help the immune system attack cancer cells, show great promise in fighting leukemia in children.
  • Radiation therapy: To limit the side effects of radiation therapy, radiation oncologists at Rush use the latest techniques — including image-guided radiation therapy — to deliver targeted radiation to cancer cells, without harming healthy, noncancerous tissue. 
  • Stem cell transplants: If your child has an aggressive form of leukemia, or the disease does not respond well to treatment, your child’s care team may recommend a stem cell transplant — also called a bone marrow transplant — along with chemotherapy. Stem cells, or immature blood cells, are first removed from your child or a donor and frozen. Your child then would receive chemotherapy to kill the recurring cancer cells. Afterwards, your child would be given the stem cells via an infusion, which would naturally restore any healthy cells killed by the chemotherapy. 
  • Alternative and complementary therapies: Your child can receive counseling, massage therapy, acupuncture, nutrition counseling and other supportive therapies from Rush’s Cancer Integrative Medicine Program
  • Palliative care: Pediatric palliative care specialists offer an additional layer of care and support to your child as they undergo treatment for bone cancer. Palliative care focuses on improving your child’s quality of life, managing pain and providing emotional support for your child and your family.

Long-term monitoring and support

Your child’s care team will follow your child through adulthood to quickly identify and address any cancer recurrence.

At Rush’s long-term follow-up clinic, your child’s care team will include an oncologist, nurse educator and psychologist. They work closely with your child’s primary care clinician to monitor your child for possible late effects of leukemia.

With coordinated medical, rehabilitation and psychosocial care, Rush provides a comprehensive continuum of care for other health, physical and development problems that are sometimes associated with leukemia in children. 

Rush also provides comprehensive, multidisciplinary care for adults with leukemia.