WHAT IS ACUTE MYELOID LEUKAEMIA (AML) IN CHILDREN

Acute myeloid leukaemia is an overproduction of immature myeloid cells, called myeloblasts that tend to fill up the bone marrow and obstructs its making healthy blood cells putting the child at increased risk of infection. More boys than girls develop AML, though the reason is not determined for that. 

Types of AML in Children  

M0: acute myeloid leukaemia with minimal evidence of myeloid differentiation

M1: acute myeloblastic leukaemia without maturation

M2: acute myeloblastic leukaemia with maturation

M3: acute promyelocytic leukaemia (APL)

M4: acute myelomonocytic leukaemia

M5: acute monocytic/monoblastic leukaemia

M6: acute erythroleukaemia

M7: acute megakaryoblastic leukaemia

AML type M4 & M5 are the most frequent with M0 and M6 being the rarest.

WHAT ARE THE SYMPTOMS OF ACUTE MYELOID LEUKAEMIA (AML) IN CHILDREN 

Childhood leukaemia develops quickly. The symptoms include: 

• Frequent, persistent infections

• Unusual bleeding and bruising

• Tiredness

• Paleness

• Breathlessness

DIAGNOSIS AND TREATMENT 

Diagnosis 

1. diagnosis can be made on the basis of a blood test, that will reveal low numbers of normal white blood cells and large numbers of abnormal white blood cells.

2.  the child will be referred to hospital for further tests. A sample of bone marrow will be taken to confirm the exact diagnosis.

Treatment: The treatment of AML in Children is shorter and more intensive usually lasting for around six months. The child will usually be admitted to hospital for the full duration of treatment  because he or she may require a high level of palliative care.

1. Chemotherapy. A combination of chemotherapy drugs and steroid medicines is given.

There are two phases of treatment :

Phase 1.  Remission induction- a state called remission to be achieved is targeted where almost all leukaemic cells have been killed, allowing production of normal blood cells to resume. It usually includes one or two blocks of a combination of chemotherapy drugs in high doses given over a few days at intervals of one or two weeks.

Children with AML are usually given intrathecal chemotherapy after each of the first two blocks of chemotherapy which  involves injecting chemotherapy drugs into the spinal fluid . 

Phase 2.  Post Remission Treatment

1. Post-remission treatment aims to destroy any remaining leukaemic cells in order to prevent the disease returning & the phase usually involves two - three more blocks of the same drugs used in remission induction.

2. Sometimes it is necessary to use additional drugs or higher doses of the same drugs; this is known as intensification. Stem cell (bone marrow) transplantation is a special case of intensification that  enables doctors to give higher doses of drugs than would otherwise be possible.

3. Children undergoing stem cell transplantation will need Radiotherapy as part of the preparation for the transplant.

IMPORTANT INFORMATION

Side Effects of Treatment 

• Hair loss

• Nausea and vomiting

• Increased appetite

• Mood Swings 

• Weight gain

• Irritability