What to know about acute myeloid leukemia in children

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Leukemia is the most common type of cancer in children. It accounts for about 30% of childhood cancer diagnoses.

The National Cancer Institute reports that nearly 5 in 100,000 children each year have new cases of leukemia. However, this is based on data from 2014–2018, and the number of new cases rose by approximately 0.7% each year from 2009–2018.

There are two main subtypes of childhood leukemia: AML and acute lymphoblastic leukemia (ALL). AML is much less common than ALL. It accounts for only 18% of cases.

AML causes bone marrow to produce large numbers of abnormal blood cells. These leukemia cells do not leave enough room for normal red blood cells, white blood cells, and platelets.

Learn more about the types of childhood leukemia here.

The following symptoms may occur in children with AML:

• Fatigue: A lack of red blood cells can cause anemia, making a child feel tired or lethargic.
• Bruises and bleeding: A child may bleed or bruise more easily, or these issues may take longer to go away.
• Infections: A child may develop more infections due to having fewer white blood cells.
• Aches and pains: A child may have aching limbs.
• Feeling generally unwell: Children with AML may have general symptoms similar to those of a viral infection. If these last for more than a week or two, schedule an appointment with the child’s doctor.

Children may experience different combinations of these symptoms, and the symptoms sometimes develop quickly.

Learn more about early symptoms of childhood leukemia here.

The American Cancer Society (ACS) explains that in most cases, the cause of childhood leukemia is unknown. What is clear is that certain changes in DNA cause bone marrow cells to grow excessively and turn into leukemia cells.

The ACS also cites research suggesting that a combination of genetic and environmental factors causes many childhood leukemia cases.

Certain genes influence how the body breaks down and removes harmful chemicals, but some people have less effective versions of these genes. The body of someone who inherits this genetic issue may be unable to get rid of harmful chemicals after exposure.

Risk factors

Behavioral factors that increase the risk of cancer in adults do not play a major role in childhood cancer rates. These factors relate to diet, physical activity levels, and body weight, for example. They take years to increase the risk of cancer.

In children, the following factors may increase the risk of developing leukemia:

• having a sibling with leukemia
• exposure to high levels of radiation
• having had chemotherapy or another type of cancer
• taking medications that suppress the immune system in preparation for an organ transplant
• having Down syndrome
• exposure to certain chemicals, such as benzene and household pesticides
• having an inherited immune system condition, such as ataxia-telangiectasia, a rare disorder that causes uncoordinated movements

The following may also have a link to childhood cancer, though the association is still unproven:

• living near a nuclear power plant
• exposure to electromagnetic fields
• chemical contamination of ground water

Overall, there is no known way to prevent childhood leukemia.

Doctors evaluate for leukemia using one or more of these processes:

• performing a physical exam
• taking a medical history
• looking at results of blood tests, such as
  • a complete blood count
  • blood chemistry tests
• looking at results of imaging tests, such as:
  • CT scans
  • MRI scans
  • X-rays
• taking a lymph node biopsy
• taking a bone marrow biopsy
• taking a lumbar puncture, which involves removing a sample of the cerebrospinal fluid that surrounds the brain and spinal cord

The Leukemia and Lymphoma Society note that the following are treatments for childhood AML:

• Combination chemotherapy: This can kill leukemia cells in different ways depending on the combination of drugs involved.
• Stem cell transplants: Doctors recommend these when AML has returned after drug therapy or when the risk is high.
• Central nervous system prophylaxis: This involves injecting chemotherapy drugs into the spinal fluid to prevent the spread of AML to the brain and spinal cord.

Learn about different types of chemotherapy here.

The 5-year survival rate for children with AML has risen over time. It now ranges from 65–70%, according to the ACS. This measurement shows the likelihood of living for at least 5 years after the diagnosis.

Survival rates are based on averages of past data. They do not reflect each child’s situation or more recent advances in detection and treatment.

Also, survival rates vary for children with different subtypes of AML. For example, the cure rate for children with a subtype called acute promyelocytic leukemia (APL) is higher than 80%, the ACS says. APL causes an excess of immature white blood cells to accumulate in the bone marrow.

Another thing to keep in mind is that for children who are free of AML 5 years after their diagnosis, the cancer is unlikely to return, the ACS report.

Overall, because their bodies are younger, children may respond better to treatment than adults with the same disease.

Find support resources for children with leukemia here.

AML causes bone marrow to produce large numbers of abnormal blood cells. It is not the most common type of leukemia in children.

Experts have recognized some possible risk factors, but they have not found a way to prevent the cancer. Doctors use blood tests, imaging tests, and biopsies to evaluate the condition.

If symptoms of AML last for longer than a week or two, make an appointment with the child’s doctor.