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Leukemia is a type of cancer that originates in white blood cells. It is the most common childhood cancer, often diagnosed at a median age of 5 to 6 years. However, it can also occur in infants (less than one year old) and in children older than 10 years. Leukemia in infants and children over 10 years of age generally has a poorer prognosis, whereas cases diagnosed between 1 and 10 years tend to have better cure rates and a more favorable outlook. In a conversation with Jagran English, Dr. Nithin SG, Consultant and Medical Oncologist at CK Birla Hospital in Delhi, discussed how to detect leukemia in children at an early stage.

How to Detect Leukemia in Children at an Early Stage?

Early detection of leukemia is crucial and can be done by recognizing its symptoms and signs. These symptoms can be categorized into constitutional symptoms and those specific to leukemia. Since leukemia is a cancer of the blood, it leads to various blood-related abnormalities. Affected children may experience excessive bleeding from the nose, gums, or other body orifices, such as the urinary tract. They may also show increased bruising (ecchymosis), where even minor trauma or handling can result in bluish patches on the skin due to bleeding beneath the surface. Another significant symptom is the enlargement of lymph nodes, often noticeable in the neck, armpits, or groin. These swollen lymph nodes are usually painless but feel firm and rubbery.

According to Dr. Nithin SG, children with leukemia may also experience bone pain, particularly at night, making it difficult for them to run or play. Recurrent headaches and vomiting are also common, sometimes accompanied by visual disturbances such as blurred vision. Additionally, affected children have a weakened immune system, leading to frequent infections, especially respiratory tract infections or diarrhea, which may not respond well to antibiotics. Some children develop red spots on the skin due to subcutaneous bleeding, or bleeding within the eyes, leading to red discoloration.

Apart from these specific symptoms, there are also general (constitutional) symptoms such as unexplained weight loss, difficulty gaining weight, reduced appetite, generalized weakness, and easy fatigability. In infants, leukemia may present as excessive sleepiness, refusal to breastfeed, and minimal activity. Some children also develop abdominal distension due to an enlarged liver and spleen, leading to a sensation of fullness even after consuming small amounts of food, said Dr. Nithin SG.

Along with symptoms, certain physical signs may indicate leukemia. These include the presence of red or blue discolorations on the skin due to bleeding, gum hypertrophy (swollen, tender gums), and an enlarged abdomen due to liver and spleen involvement. In some cases, testicular enlargement may be observed. Another significant sign is bone tenderness, particularly in the sternum (breastbone), where even a slight touch can cause severe pain.

Dr. Nithin SG in conclusion emphasised that if parents notice any of these symptoms or signs, they should seek immediate medical attention from a pediatrician or oncologist. The diagnosis of leukemia is typically made through blood tests. Routine blood investigations may reveal abnormalities in hemoglobin levels, white blood cell (WBC) counts, and platelet counts. Typically, platelets are reduced, WBC counts are elevated, and hemoglobin levels are lower than normal. The presence of immature cells (blasts) in the blood is also a key indicator. Additional tests, such as a peripheral blood smear, flow cytometry, and bone marrow aspiration biopsy, help confirm the diagnosis and determine the specific type of leukemia. Advanced genetic testing, such as next-generation sequencing, is now also used for better classification and treatment planning.