Journal of Leukemia
Open Access

The Significance of Genetic Mutations in Pediatric Acute Myeloid Leukemia

Ruby Njeri^{* *}Correspondence: Ruby Njeri, Department of Oncology, Mount Kenya University, Thika, Kenya, Email:

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Description

Pediatric leukemia, the most common cancer among children, has long been a subject of concern for both the medical community and the general public. Leukemia, a cancer of the blood and bone marrow, comes in various forms, but the two most prominent in children are Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML). While tremendous strides have been made in treatment and survival rates, the emotional, social, and long-term physical toll on children and their families remains a topic that demands deeper attention.

In pediatric cases, Acute Lymphoblastic Leukemia (ALL) is the most common. It originates in the lymphoid cell line, which normally produces B and T lymphocytes, essential parts of the immune system. Acute myeloid leukemia (AML), though less common in children, originates in the myeloid cell line, which normally produces red blood cells, platelets, and certain types of white blood cells. Both forms of leukemia are "acute," meaning they progress quickly and require immediate treatment upon diagnosis. Chronic forms of leukemia, such as Chronic Lymphocytic Leukemia (CLL) or Chronic Myelogenous Leukemia (CML), are exceedingly rare in children.

Advances in treatment

The survival rates for pediatric leukemia have improved dramatically over the past few decades. However, these statistics don't diminish the fact that treatment is often grueling, with serious side effects and long-term consequences. Chemotherapy, the cornerstone of leukemia treatment, has evolved significantly. It involves a combination of drugs that kill rapidly dividing cells, a characteristic of cancer cells. Unfortunately, chemotherapy doesn’t discriminate between cancerous and healthy cells, which is why children undergoing treatment often experience side effects like hair loss, nausea, and fatigue. More serious side effects can include long-term damage to the heart, lungs, and brain. For some, the treatment itself becomes almost as harrowing as the disease.

Immunotherapy, a more recent development, has shown promise in treating pediatric leukemia, particularly in children with relapsed or refractory ALL. One such treatment, CAR T-cell therapy, involves modifying a patient's own immune cells to attack cancer cells. This form of personalized medicine has produced remarkable results, with some children achieving remission after other treatments had failed. However, immunotherapy can come with its own set of complications, such as Cytokine Release Syndrome (CRS), which can cause severe inflammation and organ damage.

Bone marrow transplants are another critical tool in the fight against leukemia, particularly for children with AML or relapsed ALL. A transplant can replace the child’s diseased bone marrow with healthy stem cells from a donor, effectively "replace" the immune system. But finding a matching donor can be a long and uncertain process, and the procedure itself is risky. Children undergoing bone marrow transplants are at high risk for infections, graft-versus-host disease, and other complications.

While these treatments have improved survival rates, they often come with significant physical and emotional costs. The long-term effects of treatment on a child’s developing body can be profound, ranging from secondary cancers to cognitive impairments and growth delays.

Conclusion

Pediatric leukemia remains one of the most challenging diagnoses a child and their family can face. While advances in treatment have led to remarkable improvements in survival rates, the physical, emotional, and socioeconomic toll of the disease cannot be overlooked. Continued research, equitable access to care, and comprehensive survivorship support are essential to ensuring that every child with leukemia has the opportunity to not only survive but to thrive. The fight against pediatric leukemia is far from over, but with ongoing innovation and a commitment to compassionate care, there is hope for a future where this disease no longer robs children of their health and their childhoods.