Early Detection, Diagnosis, and Prognosis of Childhood Leukemia

Learn about the signs and symptoms of childhood leukemia, the tests that may be done for it, and the outlook for those with a diagnosis.

Can childhood leukemia be found early?

At this time, there is no widely recommended screening test to look for leukemia before it starts to cause symptoms. Childhood leukemia is often found because a child has signs or symptoms that prompt a visit to the doctor. The doctor then orders blood tests, which might point to leukemia as the cause. The best way to find these leukemias early is to pay attention to the possible signs and symptoms of this disease.

For children at increased risk

For children known to be at increased risk of leukemia (because of a genetic condition such as Li-Fraumeni syndrome or Down syndrome, for example), most doctors recommend careful, regular medical visits to watch for signs or symptoms of leukemia.

Regular medical care is also important for other children at higher risk of leukemia, such as people who have been treated with chemotherapy, radiation therapy, or who are taking immune system-suppressing drugs. The risk of leukemia in these children, although higher than in the general population, is small.

What are the signs and symptoms of childhood leukemia?

Leukemia symptoms can vary and often result from leukemia cells crowding out healthy blood cells. Many of these symptoms can also have other, more common causes. If your child has any of the following symptoms, it is important to see a doctor to find out the cause.

Signs and symptoms can include:

• Low energy, weakness, or pale skin (from low red blood cells)
• Frequent infections or fevers (from low normal white blood cells)
• Easy bruising or bleeding (from low platelets)
• Pain in the bones or joints
• Swelling in the belly (from a large spleen or liver)
• Enlarged lymph nodes in the neck, armpits, above the collarbone, or groin
• Weight loss and low appetite
• Coughing or trouble breathing

Most of these symptoms are likely due to other causes, but checking with a doctor is important for your child's health.

How is childhood leukemia diagnosed?

Diagnosing childhood leukemia often involves blood tests, a bone marrow biopsy, and sometimes a spinal tap (a procedure that collects spinal fluid). If leukemia is found, more detailed tests will be done on the blood, bone marrow, and spinal fluid to learn more about the leukemia cells and how best to treat them.

These tests are also used to help track how well treatment is working.

Survival and outlook for childhood leukemia

After a leukemia diagnosis, many people want to understand what to expect. While every child’s experience is different, survival rates can offer a general picture based on past outcomes in children with similar types of leukemia.

Survival rates are a way to measure how many people survive a certain type of cancer over time. Survival rates are often reported as 5-year survival rates, which refer to the percentage of children who live at least 5 years after their cancer is diagnosed. Of course, often children live much longer than 5 years (and many are cured). Some people find this information helpful, while others prefer to focus more on the treatment plan and next steps.

A child’s outlook depends on many factors, including the type of leukemia they have, how well it responds to treatment, and certain features of the leukemia cells. These are known as prognostic factors, and they help doctors tailor treatment and better predict the likely course of the disease.