Treatment of acute lymphoblastic leukemia in children in israel
Acute lymphoblastic leukemia (ALL) is an oncological disease of the white blood cells, which are normally responsible for the functioning of the body immune system.
There are two main types of white blood cells — myeloid and lymphoid. Acute lymphoblastic leukemia affects lymphoid cells. White blood cells altered by the pathological process accumulate in the central nervous system, in particular in the spine or in the brain cavity. It is rather difficult to diagnose the disease at its early stages. If there is a suspicion of ALL in a child, it is necessary to be examined by a specialist and promptly start treating acute lymphocytic leukemia.
What does ALL (acute lymphoblastic leukemia) diagnosis mean?
In this disease, the affected cells begin to lose their ability to functionalize as normal blood cells. Malignant cells are immature lymphocytes that have lost the ability to defend the body against bacterial and viral diseases. That is why ALL in children (Acute lymphocytic leukemia) is accompanied by a frequent increase in body temperature and susceptibility to infectious diseases. This type of acute lymphocytic leukemia in children is most common.
What are the symptoms of acute lymphoblastic leukemia in children?
Leukemic cells spread to the bloodstream throughout the human body like other blood cells. Signs of the disease may depend on how many malignant cells are in the bloodstream and where they are located. A small number of red blood cells leads to a disruption in oxygen supply to the body. As a result, anemia begins to develop, the patient looks tired, weak and pale. If there are not enough platelets, even a minor scratch in a small child can provoke bleeding, which is sometimes difficult to stop. Therefore, it is necessary to begin treatment of acute lymphoblastic leukemia as early as possible.
The most common symptoms when diagnosed with ALL are:
- pinpoint bleeding in the eyes or skin (occurred as small red dots);
- frequent infectious diseases turning into chronic forms;
- enlargement of lymph nodes, spleen, liver;
- bleeding, bruising;
- pain in joints, bones.
Sometimes malignant cells are localized in the central nervous system and cause severe headaches, sometimes accompanied by vomiting. Children with ALL usually do not have these symptoms.
Acute lymphoblastic leukemia diagnostics
If a child has alarming symptoms, firstly the doctor sends him for general blood tests. In this case, the blood is checked for the presence or absence of malignant cells in the blood, the number and shape of red blood cells are also detected. In order to confirm the ALL diagnosis, a bone marrow sample is taken from the patient for microscopic examination. The procedure is performed as follows: a needle is inserted into the cavity of a large bone (for example, a femur), and then a small amount of bone marrow fluid is taken. Based on the study results, an oncologist can accurately determine the presence or absence of ALL in a child.
If leukemic cells are found in the bone marrow, the oncologist sends the patient for additional checks and examinations in order to determine the scale and severity (stage) of acute lymphoblastic leukemia. A lumbar puncture may be prescribed — a small amount of fluid extraction from the lower parts of the spinal column — in order to determine the count of pathological cells in it.
Comment by Dr. Michael Weintraub, Head of the Pediatric Oncohematology Department, the Hadassah MC:
«In Israel, the survival rate of children with ALL has increased significantly over the past 35 years. This is considered the most important medical achievement in Israel in the treatment of acute lymphocytic leukemia. If less than 5% of children survived within 5 years from the moment of diagnostics earlier, today more than 85% of children survive during this period.»
Causes of Acute Lymphoblastic Leukemia
In addition to radiation exposure of the patient’s mother during pregnancy or genetic diseases (for example, Down’s syndrome), scientists find it difficult to discuss risk factors for the development of this disease type. It is only known that boys have it more often than girls; and that white children have more cases than black children. But they cannot explain why one child is sick and the other is not.
Treatment methods of acute lymphoblastic leukemia used in Israel
The main treatment method for the ALL is chemotherapy. Medicines are selected individually depending on the disease subtype and may be different for patients.
ALL treatment in a child is a complex and painstaking process. It is necessary to take large doses of medicines exactly in time for 2-3 years. Therefore, it is extremely important to provide treatment of acute lymphocytic leukemia as it is done in the Hadassah MC, under monitoring by a team of specialists who have clinical experience and professional knowledge of the ALL treatment in children.
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Clinical research and development of new treatment methods of acute lymphoblastic leukemia in Israel
Most children with ALL take part in clinical trials when a new drug or a new combination of drugs is tested and then it is compared with conventional treatment methods.
Before starting an experiment, it can be difficult to determine if a new treatment is more effective than the old one. However, success in the treatment of acute lymphoblastic leukemia is usually the result of such clinical trials. Specialists continue to conduct them in order to develop modern and more successful treatment methods, to reduce the disease side effects.
What factors ensure successful ALL treatment in children?
The efficiency of acute lymphoblastic leukemia treatment is determined by many factors. However, the most important and decisive one is getting the best possible, high-quality treatment at a medical center that particularly specializes in the ALL treatment in children. Yet despite good treatment, some children are much more difficult to help than others. In the past, the prognosis could be determined based on the child’s age and the white cells number in the blood at the time of diagnostics. For example, children between 1 and 9 years old have a better chance of survival than children younger or older than the mentioned age. However, if only these factors are taken into account, it will be a crude approach of determining the prognosis.
Today, it is known that a subtype of acute lymphoblastic leukemia has a decisive influence on the situation outcome. For example, some chromosomal changes are observed in the ALL subtype which is characteristic of infants. This subtype is poorly treated, and even with the available treatment methods the survival rate is low. In older children, another ALL subtype (with different genetic changes) is usually observed; it responds to treatment better.
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In modern conditions of Israeli clinics, it is possible to most accurately establish a subtype of acute lymphoblastic leukemia (ALL) according to a genetic change. The treatment plan is developed by specialists in compliance with the diagnosis.
Specialists of the Hadassah MC international department will help to organize the ALL diagnostics and treatment of a child with the best pediatric oncohematologists of our hospital.
In order to find out more information about the treatment of children in Israel, as well as to receive a preliminary medical plan and a treatment cost, you can: