Childhood Leukemia Diagnosis
Childhood leukemia is diagnosed by taking a sample of bone marrow from the hip with a needle. A spinal tap is also performed to determine whether leukemia has affected the central nervous system.
At the Children's Cancer Hospital, these procedures are performed under anesthesia for minimal discomfort to your child. Special doctors called hematopathologists use a full battery of laboratory tests to identify the leukemia type.
Getting a Second Opinion at MD Anderson
The pathologists at MD Anderson are highly specialized in diagnosing and staging childhood leukemia, and we welcome the opportunity to provide second opinions.
If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.
Childhood Leukemia Staging
(source: National Cancer Institute)
Acute Lymphoblastic Leukemia (ALL)
Because ALL is a disease of the blood cells, it has already spread throughout the body at diagnosis. Once childhood ALL has been diagnosed, tests are done to find out if the cancer has spread to the central nervous system (brain and spinal cord), testicles or to other parts of the body. There is no staging system for ALL. Risk groups are used to plan treatment.
The extent or spread of cancer is usually described as stages. For childhood acute lymphoblastic leukemia (ALL), risk groups are used instead of stages.
Risk groups are described as:
Standard (low) risk: Includes children aged 1 to 9 years who have a white blood cell count of less than 50,000/µL at diagnosis.
High risk: Includes children younger than 1 year or older than 9 years and children who have a white blood cell count of 50,000/µL or more at diagnosis.
Other factors that affect the risk group include the following:
- Whether the leukemia cells formed from B lymphocytes or T lymphocytes.
- Whether there are certain changes in the chromosomes of the lymphocytes.
- How quickly the leukemia responds to initial therapy.
It is important to know the risk group in order to plan treatment. Children with high risk ALL usually receive more aggressive treatment than children with standard risk ALL.
Acute Myeloid Leukemia (AML)
There is no standard staging system for childhood AML, childhood chronic myelogenous leukemia (CML), juvenile myelomonocytic leukemia (JMML), transient myeloproliferative disorder (TMD) or myelodysplastic syndromes (MDS). In childhood AML, the subtype and whether the leukemia has spread outside the blood and bone marrow are used to plan treatment.
Childhood AML is described as newly diagnosed, in remission, or recurrent.
Newly diagnosed childhood AML: The disease has not been treated except to relieve symptoms such as fever, bleeding, or pain, and one of the following is true:
- More than 20% of the cells in the bone marrow are blasts (leukemia cells), or
- Less than 20% of the cells in the bone marrow are blasts and there is a specific change in the chromosome.
Childhood AML in remission: The disease has been treated and the following are true:
- The complete blood count is almost normal.
- Less than 5% of the cells in the bone marrow are blasts (leukemia cells).
- There are no signs or symptoms of leukemia in the brain, spinal cord, or other parts of the body.
Recurrent childhood AML has recurred (come back) after it has been treated. The cancer may come back in the blood and bone marrow or in other parts of the body.
If your child has been diagnosed with leukemia, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.
Why Choose MD Anderson?
- The Children’s Cancer Hospital is within one of the top-ranked cancer centers in America
- Access to novel therapies and state-of-the-art technologies before most children’s hospitals
- We see more types of cancer than any other children’s hospital in Texas
- Family-centered care that actively involves parents in their child’s treatment
- A strong cancer research program focused on developing new therapies for pediatric patients
- Comprehensive support services such as an accredited school program, creative arts, child life and career counseling
- An Adolescent and Young Adult Program that specializes in the unique medical and psychological needs of patients aged 15-25