Treatment
Leukemia is a very aggressive disease. Therefore the treatment must be started as soon as possible. Already the well-founded suspicion is sufficient to initiate the therapy in affected children.In principle, therapy should only be carried out in a specialized treatment center for children and adolescents suffering from cancer (pediatric hematology and oncology), these are usually located at university clinics and large hospitals.
The most important pillar of therapy is chemotherapy. The aim is to destroy the leukemia cells as completely as possible. Only in this way can the bone marrow resume its normal, blood-forming function.
To achieve the best possible effect, several different chemotherapeutic agents, also known as cytostatics, are used in combination. This is then referred to as “polychemotherapy”. You can find more information on this topic here: Performance of chemotherapy If the central nervous system (i.e. the brain and spinal cord) is affected by leukemia cells, under certain circumstances, the skull can be irradiated.
However, since many late complications can occur, the decision must be carefully considered. In principle, however, no child in the 1st year of life may be irradiated. In certain cases a stem cell transplantation is necessary.
The first step is a high-dose chemotherapy, which is intended to destroy all cells in the bone marrow, followed by a bone marrow transplantation in a specialized center. You can find more information on this topic here: Bone marrow donation In Germany, almost all children and adolescents with leukemia are treated in so-called “therapy optimization studies”. The aim is to ensure the best possible treatment for sick children.
Within the controlled clinical studies there is a large exchange of information. Thus, a treatment based on the latest scientific findings can be made possible. If no radiation or bone marrow transplantation is necessary, the therapy of leukemia in children takes about 2 years.
It is divided into different phases, which last about half a year and are in principle associated with permanent hospitalization. In the last phase of treatment, the maintenance or permanent therapy, the children receive relatively moderate chemotherapy for about 1.5 years, i.e. relatively low doses. Since the cytostatic drugs are usually administered in tablet form, a large part of the last part of the treatment can be done at home.
In the case of an additional bone marrow transplantation, the duration depends on the appropriate donor search. Once a suitable stem cell donor has been found, the therapy takes about 2-2.5 years. In the treatment of leukemia, children suffer from hair loss.
Like almost all chemotherapeutic drugs, the drugs used in leukemia therapy have a very aggressive effect on the human body. Unfortunately, they are not exclusively effective against leukemia cells. Especially fast dividing cells, such as mucous membrane cells or hair root cells are also affected.
As a result, the children lose all their hair within a short time, including eyelashes and eyebrows. Although completely painless, this hair loss is a serious side effect for many children and their families. Fortunately, the hair grows back quickly after the end of chemotherapy.
For the time during the therapy, there is also the possibility of special wigs. You can find more information on this topic here: Chemotherapy side effectsAs the therapy of leukemia must be very aggressive, there are unfortunately many side effects. One of the main problems is a maximally “downed” immune system.
Affected children are very susceptible to e.g. pneumonia or even blood poisoning. In order to be able to better treat the side effects (nausea, vomiting, inflammation of the oral mucosa, bleeding, anemia, infections…), the so-called “supportive” therapy is of great importance. This includes all supportive measures, such as medication against nausea and vomiting, antibiotics against infections, etc. Affected children should have as little contact with potential germs as possible during treatment, which is why they are usually isolated during the course of chemotherapy. In addition, both chemotherapy and radiation therapy can cause further tumours to develop during the course of life.
