Special Considerations for Children with Blood Cancer

Dealing with a diagnosis of blood cancer is never easy, and there are some unique challenges when the person who is diagnosed is a child. The types of cancer that occur in children are often different than cancers in adults, and there are differences in treatment between children and adults. Although the survival rate for blood cancers in children has been steadily rising, there is growing awareness of the long-term effects from the treatment for cancers in children.¹

How blood cancer develops in children

Cancers occur when there are changes to the DNA of the cell. DNA is the genetic material of the cell that includes instructions for how a cell should normally divide and develop. Each time any cell in the body divides, it makes a new copy of its DNA. Sometimes errors occur during this replication, and some of these errors can cause cancer to develop.¹

While some of these errors to the DNA, called mutations, can be passed from parents to children (inherited genes) or occur from exposure to certain factors in the environment, it is still unknown what causes most cancers in children. The blood cancers that occur in children most often are the result of spontaneous mutations that occur very early in life.^1,2

One of the most common types of cancer in children is acute lymphocytic leukemia (ALL), which develops from the lymphoid stem cells in the bone marrow. Other blood cancers that can occur in children include acute myeloid leukemia (AML) and lymphoma. It is rare for children to develop chronic leukemia, although it does occur in some cases.¹

Treatment differences

In general, children’s cancers respond better to chemotherapy than adults with cancer. In part, this is because children can often tolerate more intense courses of chemotherapy, which targets fast-growing cells like cancer cells. Radiation therapy tends to be harder on children, as they often have more side effects than adults receiving radiation. Both chemotherapy and radiation treatments can have long-term effects on children.¹

Long-term effects from treatment

During treatment, parents of children with blood cancer are focused on what treatments will provide the best chance of cure or remission, as well as the short-term side effects and how those will impact their child’s life. With more children surviving blood cancer, there is a better understanding of how some blood cancer treatments can affect people long-term. Some of the possible long-term effects from treatment for blood cancer may include:

• An increased risk of other cancers later in life
• An increased risk of heart or lung problems
• Emotional problems, such as anxiety or depression
• Slowed growth or development
• Reproductive or sexual development problems
• Learning disabilities or memory problems
• Impairment to hearing or vision
• Behavioral problems^1,3

Long-term or late effects from treatment are influenced by many factors, including the child’s age, the subtype of blood cancer, the child’s overall health, and the type of treatment received. Parents should ask their child’s doctor about possible long-term effects and what to look for.^1,3

How to help children of different age groups cope with blood cancer

Children have different needs as they age that impact how they cope with treatment for blood cancer.

• Less than 1 year of age: Babies respond to sensory comforts, like skin-to-skin contact, familiar sights and smells, and the sound of their parents’ voices talking or singing.
• Children 1-3 years of age: Young children learn through seeing, touching, and playing, and like to make their own choices. Create choices of simple rewards after treatments like stickers or which book to read, and prepare children by explaining what to expect.
• Children 3 to 5 years of age: Children of this age are becoming more aware and can benefit from seeing and touching machines or medical supplies before they are used. Comfort items like a favorite story or a stuffed animal can provide distraction and support.
• Children 6 to 12 years of age: School-aged children can understand the treatment’s purpose is to help them get well, and it’s important for them to know what to expect. They may have many questions, which doctors or nurses can help answer.
• Teenagers: Teenagers are often more focused on relationships with friends and their appearance, and they may feel strong emotions on how cancer is affecting their life. Help them connect with friends and other kids with cancer, and include teens in treatment discussions and choices.²

Getting support for whole family

When a child is diagnosed with blood cancer, it often impacts the whole family. While it’s important to give support and help the child find support through in-person or online groups, it’s equally important for parents and siblings to ask for and receive help. Support groups are available for family members, and online communities can provide opportunities to connect with others at any time of the day or night. Professional help of a psychologist, psychiatrist, therapist, or social worker can also provide family members with tools and resources for their mental health.^1,2