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CHILDREN’S HEALTH ISSUE Childhood Leukemia By Jennifer Aleksa & Angie Edwards-Rash What is Childhood Leukemia? Leukemia is a typically non-inherited disease in which large numbers of immature, abnormal white blood cells are produced in the bone marrow Abnormal white blood cells flood the bloodstream, affecting the production of oxygen-producing red blood cells and platelets Normal white blood cells protect the body from infection and disease A large production of abnormal white blood cells makes makes the body very susceptible to infections and diseases Leukemia affects more than 3,500 children in the US every year Common Forms of Childhood Leukemia Acute Lymphoblastic Leukemia (ALL) – Very rapid production of abnormal white blood cells known as the lymphocytes that are released into the bloodstream before they mature. This is the most common form of Leukemia and strikes children three years of age and younger and young teenagers. Accounts for 75% of all pediatric cases Common Forms of Childhood Leukemia Acute Myelogenous Leukemia (AML) – A very rapid production of abnormal white blood cells known as the myelocytes. This form of Leukemia strikes children as well as adults. Accounts for 20% of all pediatric cases Chronic cases of leukemia are also present; these are very slow growing cancers affecting myelocytes and lymphocytes. In a chronic case, the white blood cells are more mature and they are produced at a much slower rate What are the Symptoms? Frequent Infections and fevers Easy bruising or bleeding Bone or joint pain Unusual fatigue and breathlessness during activity Loss of appetite; unexplained weight loss Night sweats Swollen glands (usually lymph nodes) Anemia Socio-economic or Ethnic factors in Survival and Occurrence Few studies to date on socio-economic or ethnic factors related to occurrence One study conducted in at St. Judes Children’s Hospital indicated that the survival rate is lowest among minority children (African Americans, Hispanic and Native American) compared to Caucasian and Asian/Pacific Islander children Highest survival rate found in Asian children Higher survival rate in females than in males One study conducted in Colorado indicated that the occurrence of leukemia was higher in children living in an urban area rather than a rural area Treatments of Leukemia Intrathecal Chemotherapy – a cancer-killing drug that is administered into the cerebrospinal fluid around the brain and spinal cord to keep it from entering the child’s central nervous system Radiation therapy – high energy rays are aimed at the affected area to shrink tumors and keep cancer cells from growing (often used in tandem with chemotherapy) Bone Marrow Transplant – Stem cells (immature blood cells) are taken from healthy bone marrow and are introduced into a sick child’s body to create a new “blood factory” that will hopefully produce healthy, mature white blood cells Maintenance Chemotherapy – administered in cycles over 2 to 3 years to avoid reoccurrence. Leukemia will almost always reoccur if this chemotherapy is not received Various new drugs – many ongoing clinical trials introduce new drugs that may offer more effective treatment with minimal impact on quality of life Long Term and Late Effects of Treatment A long-term effect is a medical problem that persists for months or years after treatment A late effect is a medical problem that does not develop until years after treatment ends. Both long-term and late effects include: Infertility Cognitive Effects – include learning disabilities in math, spatial relationships, problem solving, attention span, reading and spelling, processing information, organization and fine motor coordination (poor handwriting) Physical Development – ongoing fatigue, growth delays, thyroid dysfunction, hearing and vision loss and development of secondary cancer Psychological Development – childhood leukemia survivors are more likely to experience mood swings, behavioral changes, depression and posttraumatic stress disorder Drug therapy – drug therapy in general has been associated with heart and lung problems, low testosterone levels in boys and premature ovarian failure or premature menopause in girls. Infertility has also been lined to drug therapy How Can Educators Provide Support? Encouraging words Letting the student know that they are missed when they are out of school Keeping in contact with student while they are out of school Provide accommodations Home bound services How to help a student transition back into school Have the school nurse talk to the class about leukemia before student comes back so that he or she is not overwhelmed with questions. ( age appropriate) Have the student share any information if they choose about where they have been. Provide a cozy place for the student to rest to or allow the student to rest in the nurses office (leukemia cause’s fatigue). Keep other students with common colds or who become sick while in school away from student with leukemia. Sanitize students desk before use Hand sanitize/ wash often The smiling face of Acute Lymphoblastic Leukemia (ALL) Parker Ann Aleksa 10 years old, 3rd grader Diagnosed with ALL 1 yr ago Has not been affected mentally, physically other than hair loss and facial features, or emotionally Remains positive, up beat, and active How Parkers school welcomed her back Teachers coordinated the whole school to wear the same bandana that parker wore on her 1st day back to school. Bandana Bonanza!