## What is leukemia? Leukemia is a blood and bone marrow disease that disrupts the process of maturation of white blood cells — [lymphocytes](https://ul.orna.me/KOge/librarybiomarker?id=135) — which the body needs to fight infections. There are too many immature white blood cells in the bone marrow of patients with [leukemia](https://ul.orna.me/KOge/librarydisease?id=6). These cells are not able to function properly and displace healthy white and red blood cells, called [platelets](https://ul.orna.me/KOge/librarybiomarker?id=83). This weakens the body’s defenses against infections and bleeding, and almost all the normal processes associated with blood formation are disrupted. The disease develops quickly and treatment must begin quickly since the success of therapy is directly related to how soon treatment was started. ## What should be a warning sign? Frequent infectious diseases in the absence of apparent causes if a child goes to kindergarten for the first time and "collects" sorenesses one by one, this is not an issue. But if it happens frequently, or if the child only has contact with a limited number of people, it can be the cause for alarm: - Constantly high temperature (above 100 °F) without other manifestations of SARS - Fever spikes from normal to 98.6°F–100 °F or higher, which are not related to taking medications or external manifestations of the disease - The appearance of bruises "by touch" - Prolonged bleeding, even from minor cuts or abrasions - Small reddish spots on the skin (micro bleeding at the capillary level) - Bruised bones and joints - Constant lethargy, weakness, sleepiness - Shortness of breath - Sudden loss of appetite and weight loss - Pale skin - Excessive sweating without physical activity - Swelling of lymph nodes ## What should you do? The first step is to take your child to the doctor as soon as possible. A complete blood count and biochemistry will be required. Further tests may be prescribed based on the test results. If suspicions are confirmed, the child will be referred to a pediatric oncologist, who will establish the specific form of the disease. In addition to a venous blood test, a bone marrow puncture may be required. These procedures are typically performed under anesthesia and do not have any dangerous consequences for your child's health. ## What treatment will be done? There is a possibility that in serious cases, the child would be admitted to the hospital. In most cases, the first step will be chemotherapy. Later, the treatment may be combined with radiation and immunologic therapy. In the most difficult cases, bone marrow transplantation may be required. Even after successful completion of treatment, the child will be followed up with an oncologist for years, with regular check-ups to ensure the disease has not returned. After five years the disease is considered to be in remission, and the child can return to a completely normal lifestyle. ## Who is at risk? Research shows that childhood leukemia usually develops at an early age: children between 2 and 5 years old are the most susceptible to the disease, but they also cope better. Identical twins get leukemia more often than children from single pregnancies, and even more often than fraternal twins. Leukemia more often affects children with hereditary and chromosomal diseases, including Bloom syndrome, Down syndrome, primary immunodeficiency, and Klinefelter syndrome.