3 facts about acute lymphocytic leukemia in children

September is Childhood Cancer Awareness Month. The most common type of childhood cancer is acute lymphocytic leukemia (ALL), a blood and bone marrow cancer that creates immature white blood cells that can't perform their typical functions. Because of this, the disease worsens quickly.

Most likely to occur in early childhood, ALL is more common in boys than girls, according to the American Cancer Society. Children younger than 5 are at highest risk for developing ALL.

Asmaa Ferdjallah, M.D., a Mayo Clinic pediatric hematologist and oncologist, treats children of all ages with ALL. Here's what she wants families to know about this disease:

1. ALL is rare and has a collection of persistent symptoms.

In 2023, the American Cancer Society estimates that 6,540 new cases of ALL will be diagnosed in both children and adults. This represents less than half of 1% of all cancers in the U.S.

ALL symptoms vary and can resemble symptoms of flu and other common illnesses. Dr. Ferdjallah says most high fevers, swollen lymph nodes and bruises are part of typical childhood development. Parents should call their child's health care professional if those symptoms persist, co-occur or seem unusual.

"With ALL, we often see frequent or daily high fevers that you can't explain," says Dr. Ferdjallah. "We'll often see rapid weight loss that doesn't make sense for a child's activity level. And we always ask about lumps or bumps, which can indicate swollen lymph nodes, as well as night sweats, bone pain and any new bruising or bleeding."

If your health care team suspects your child has ALL, they will draw blood for testing. "We would expect to see changes in blood counts" in a child with ALL, says Dr. Ferdjallah. "Low hemoglobin, low platelets, low neutrophils — having all these low blood counts may suggest ALL."

In addition to a blood test, health care professionals may also use a bone marrow test, imaging tests and a spinal fluid test to diagnose ALL.

Having one ALL symptom, such as a bruise or one low blood count, generally isn't something to worry about, says Dr. Ferdjallah. "ALL declares itself. It's not going to sneak up on you. It creates a constellation of symptoms that we see."

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