CHILDREN’S HEALTH CHILDREN’S HEALTH ISSUE Childhood ISSUE Childhood

LeukemiaLeukemiaBy Jennifer Aleksa &By Jennifer Aleksa &

Angie Edwards-RashAngie Edwards-Rash

What is Childhood Leukemia?What is Childhood Leukemia?

Leukemia is a typically non-inherited disease in which Leukemia is a typically non-inherited disease in which large numbers of immature, abnormal white blood large numbers of immature, abnormal white blood cells are produced in the bone marrow cells are produced in the bone marrow Abnormal white blood cells flood the bloodstream, Abnormal white blood cells flood the bloodstream, affecting the production of oxygen-producing red blood affecting the production of oxygen-producing red blood cells and plateletscells and plateletsNormal white blood cells protect the body from Normal white blood cells protect the body from infection and diseaseinfection and diseaseA large production of abnormal white blood cells A large production of abnormal white blood cells makes makes the body very susceptible to infections makes makes the body very susceptible to infections and diseasesand diseasesLeukemia affects more than 3,500 children in the US Leukemia affects more than 3,500 children in the US every year every year

Common Forms of Childhood Common Forms of Childhood LeukemiaLeukemia

Acute Lymphoblastic Leukemia (ALL) – Acute Lymphoblastic Leukemia (ALL) – Very rapid production of abnormal white Very rapid production of abnormal white blood cells known as the lymphocytes that blood cells known as the lymphocytes that are released into the bloodstream before are released into the bloodstream before they mature. This is the most common they mature. This is the most common form of Leukemia and strikes children form of Leukemia and strikes children three years of age and younger and young three years of age and younger and young teenagers. teenagers.

Accounts for 75% of all pediatric casesAccounts for 75% of all pediatric cases

Common Forms of Childhood Common Forms of Childhood LeukemiaLeukemia

Acute Myelogenous Leukemia (AML) – A very Acute Myelogenous Leukemia (AML) – A very rapid production of abnormal white blood cells rapid production of abnormal white blood cells known as the myelocytes. This form of known as the myelocytes. This form of Leukemia strikes children as well as adults. Leukemia strikes children as well as adults. Accounts for 20% of all pediatric casesAccounts for 20% of all pediatric casesChronic cases of leukemia are also present; Chronic cases of leukemia are also present; these are very slow growing cancers affecting these are very slow growing cancers affecting myelocytes and lymphocytes. myelocytes and lymphocytes. In a chronic case, the white blood cells are In a chronic case, the white blood cells are more mature and they are produced at a much more mature and they are produced at a much slower rate slower rate

What are the Symptoms?What are the Symptoms?

Frequent Infections and feversFrequent Infections and feversEasy bruising or bleedingEasy bruising or bleedingBone or joint painBone or joint painUnusual fatigue and breathlessness during Unusual fatigue and breathlessness during activityactivityLoss of appetite; unexplained weight lossLoss of appetite; unexplained weight lossNight sweatsNight sweatsSwollen glands (usually lymph nodes)Swollen glands (usually lymph nodes)AnemiaAnemia

Socio-economic or Ethnic factors in Socio-economic or Ethnic factors in Survival and OccurrenceSurvival and Occurrence

Few studies to date on socio-economic or ethnic Few studies to date on socio-economic or ethnic factors related to occurrencefactors related to occurrenceOne study conducted in at St. Judes Children’s One study conducted in at St. Judes Children’s Hospital indicated that the survival rate is lowest Hospital indicated that the survival rate is lowest among minority children (African Americans, among minority children (African Americans, Hispanic and Native American) compared to Hispanic and Native American) compared to Caucasian and Asian/Pacific Islander childrenCaucasian and Asian/Pacific Islander childrenHighest survival rate found in Asian childrenHighest survival rate found in Asian childrenHigher survival rate in females than in malesHigher survival rate in females than in malesOne study conducted in Colorado indicated that One study conducted in Colorado indicated that the occurrence of leukemia was higher in children the occurrence of leukemia was higher in children living in an urban area rather than a rural arealiving in an urban area rather than a rural area

Treatments of LeukemiaTreatments of Leukemia

Intrathecal Chemotherapy – a cancer-killing drug that is Intrathecal Chemotherapy – a cancer-killing drug that is administered into the cerebrospinal fluid around the brain and spinal administered into the cerebrospinal fluid around the brain and spinal cord to keep it from entering the child’s central nervous systemcord to keep it from entering the child’s central nervous systemRadiation therapy – high energy rays are aimed at the affected area Radiation therapy – high energy rays are aimed at the affected area to shrink tumors and keep cancer cells from growing (often used in to shrink tumors and keep cancer cells from growing (often used in tandem with chemotherapy)tandem with chemotherapy)Bone Marrow Transplant – Stem cells (immature blood cells) are Bone Marrow Transplant – Stem cells (immature blood cells) are taken from healthy bone marrow and are introduced into a sick taken from healthy bone marrow and are introduced into a sick child’s body to create a new “blood factory” that will hopefully child’s body to create a new “blood factory” that will hopefully produce healthy, mature white blood cellsproduce healthy, mature white blood cellsMaintenance Chemotherapy – administered in cycles over 2 to 3 Maintenance Chemotherapy – administered in cycles over 2 to 3 years to avoid reoccurrence. Leukemia will almost always reoccur if years to avoid reoccurrence. Leukemia will almost always reoccur if this chemotherapy is not receivedthis chemotherapy is not receivedVarious new drugs – many ongoing clinical trials introduce new Various new drugs – many ongoing clinical trials introduce new drugs that may offer more effective treatment with minimal impact drugs that may offer more effective treatment with minimal impact on quality of lifeon quality of life

Long Term and Late Effects of Long Term and Late Effects of TreatmentTreatment

A long-term effect is a medical problem that persists for months or years A long-term effect is a medical problem that persists for months or years after treatmentafter treatmentA late effect is a medical problem that does not develop until years after A late effect is a medical problem that does not develop until years after treatment ends. Both long-term and late effects include:treatment ends. Both long-term and late effects include:InfertilityInfertilityCognitive Effects – include learning disabilities in math, spatial relationships, Cognitive Effects – include learning disabilities in math, spatial relationships, problem solving, attention span, reading and spelling, processing problem solving, attention span, reading and spelling, processing information, organization and fine motor coordination (poor handwriting)information, organization and fine motor coordination (poor handwriting)Physical Development – ongoing fatigue, growth delays, thyroid dysfunction, Physical Development – ongoing fatigue, growth delays, thyroid dysfunction, hearing and vision loss and development of secondary cancerhearing and vision loss and development of secondary cancerPsychological Development – childhood leukemia survivors are more likely Psychological Development – childhood leukemia survivors are more likely to experience mood swings, behavioral changes, depression and to experience mood swings, behavioral changes, depression and posttraumatic stress disorderposttraumatic stress disorderDrug therapy – drug therapy in general has been associated with heart and Drug therapy – drug therapy in general has been associated with heart and lung problems, low testosterone levels in boys and premature ovarian failure lung problems, low testosterone levels in boys and premature ovarian failure or premature menopause in girls. Infertility has also been lined to drug or premature menopause in girls. Infertility has also been lined to drug therapytherapy

How Can Educators Provide How Can Educators Provide Support?Support?

Encouraging words Encouraging words

Letting the student know that they are Letting the student know that they are missed when they are out of schoolmissed when they are out of school

Keeping in contact with student while they Keeping in contact with student while they are out of schoolare out of school

Provide accommodations Provide accommodations

Home bound services Home bound services

How to help a student transition How to help a student transition back into schoolback into school

Have the school nurse talk to the class about leukemia before student 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 comes back so that he or she is not overwhelmed with questions. ( age appropriate) appropriate)

Have the student share any information if they choose about where Have the student share any information if they choose about where they have been. they have been.

Provide a cozy place for the student to rest to or allow the student to Provide a cozy place for the student to rest to or allow the student to rest in the nurses office (leukemia cause’s fatigue).rest in the nurses office (leukemia cause’s fatigue).

Keep other students with common colds or who become sick while in Keep other students with common colds or who become sick while in school away from student with leukemia. school away from student with leukemia.

Sanitize students desk before useSanitize students desk before use

Hand sanitize/ wash often Hand sanitize/ wash often

The smiling face of Acute The smiling face of Acute Lymphoblastic Leukemia (ALL) Lymphoblastic Leukemia (ALL)

Parker Ann AleksaParker Ann Aleksa10 years old, 310 years old, 3rdrd grader grader

Diagnosed withDiagnosed with

ALL 1 yr agoALL 1 yr ago

Has not been affected Has not been affected

mentally, physically othermentally, physically other

than hair loss and facial features, than hair loss and facial features,

or emotionally or emotionally

Remains positive, up beat, and active Remains positive, up beat, and active

How Parkers school welcomed her How Parkers school welcomed her backback

Teachers coordinated Teachers coordinated

the whole school to the whole school to

wear the samewear the same

bandana that parker bandana that parker

wore on her 1wore on her 1stst day day

back to school. back to school.

Bandana Bonanza! Bandana Bonanza!