Leukemia is a malignant disease of the blood in which the bone marrow produces abnormal white blood cells, disrupting the normal function of the hematopoietic system. Leukemia is the most common type of cancer in children. The main types of childhood leukemia include acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Treatment of leukemia in children is aimed at destroying cancer cells in the bone marrow, preventing relapse, and restoring normal blood formation.
Main methods of treating leukemia in children in Belarus
Chemotherapy
This is the primary method of leukemia treatment. Chemotherapeutic drugs destroy cancer cells and prevent their further division. Treatment is carried out in several stages:
- Induction of remission. The goal is to destroy as many leukemic cells as possible and achieve remission (absence of visible signs of disease). This stage lasts several weeks.
- Consolidation. Intensive chemotherapy continues to eliminate residual cancer cells. Treatment may include administration of drugs into the cerebrospinal fluid to prevent spread to the central nervous system (CNS).
- Maintenance therapy. Lasts 2–3 years and is aimed at preventing relapse. Chemotherapy doses are lower at this stage, and treatment is often performed on an outpatient basis.
Radiation therapy
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Used in selected cases, particularly if leukemia has spread to the central nervous system (brain and spinal cord). Radiation therapy may also be applied before bone marrow transplantation to destroy remaining cancer cells.
Bone marrow transplantation (hematopoietic stem cell transplantation)
- Indicated for children at high risk of relapse or in cases where leukemia does not respond to standard chemotherapy. Bone marrow transplantation allows damaged blood-forming cells to be replaced with healthy donor stem cells.
- Before transplantation, intensive chemotherapy or radiation therapy is administered to eliminate residual leukemic cells and suppress the immune system to prevent rejection of donor cells.
Immunotherapy
- Includes modern treatment approaches that help the immune system fight cancer cells. Examples include monoclonal antibodies that recognize and destroy leukemic cells, as well as CAR-T cell therapy, in which the child’s own immune cells are genetically modified to target leukemia.
- CAR-T cell therapy: Modified T cells are reinfused into the child’s body, where they actively seek and destroy cancer cells. This method has shown high effectiveness in children with relapsed or refractory leukemia.
Targeted therapy
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Uses drugs that act on specific molecular pathways essential for the growth and survival of leukemic cells. This approach is applied when certain genetic mutations are identified in cancer cells.
Stages of treatment
- Diagnosis and treatment planning. Includes blood tests, bone marrow biopsy, genetic and molecular analyses, and imaging studies to determine disease subtype and develop an individualized treatment plan.
- Induction of remission. The most intensive phase, aimed at destroying the bulk of leukemic cells. Children are usually hospitalized and receive combination chemotherapy.
- Consolidation (intensive therapy). Designed to prevent CNS involvement and eliminate remaining malignant cells. Intrathecal chemotherapy or radiation therapy may be used.
- Maintenance therapy. Continues for several years to prevent relapse. Lower drug doses allow the child to return to school and daily activities.
Supportive care
- Antibiotics and antifungal agents. Prescribed to prevent and treat infections, as children with leukemia have weakened immune systems.
- Blood transfusions. Used to manage anemia and thrombocytopenia. Red blood cell transfusions maintain hemoglobin levels, while platelet transfusions help prevent bleeding.
- Nutritional support. Proper nutrition plays an important role in maintaining strength and recovery. A dietitian may develop an individualized nutrition plan with essential vitamins and minerals.
- Physiotherapy. Helps maintain physical activity and restore strength after intensive treatment.
Treatment of leukemia in children is a complex and multifaceted process that includes chemotherapy, radiation therapy, immunotherapy, and bone marrow transplantation. Early diagnosis and a comprehensive, multidisciplinary approach significantly improve the chances of cure. Family support, psychological care, and continuous medical follow-up play a crucial role in successful treatment. Despite the challenges, modern therapies have achieved high survival rates and substantially improved quality of life for children with leukemia.
