Care for Children with Acute Lymphocytic Leukemia and Acute Myeloid Leukemia
Children and teens with leukemia have unique needs that can only be met by a team that's experienced in childhood leukemia treatment. Duke Children's team includes pediatric oncologists, bone marrow transplant specialists, and pediatric oncology nurses who work with social workers, psychologists, pediatricians, and others to offer comprehensive care and support. Your child receives the latest treatments and a full range of support services in our family-friendly environment.
Treatment Differs for Each Type of Leukemia that Affects Children
Leukemia is a cancer of the bone marrow, the substance inside bones that makes blood cells. Most often, leukemia affects the white blood cells that help fight infection, but it can affect red blood cells that carry oxygen, and platelets that help with blood clotting.
The most common types of leukemia in children include:
- Acute lymphocytic leukemia (ALL)
- Acute myeloid leukemia (AML)
Duke Children’s pediatric cancer doctors have the skills and expertise to treat all types of childhood leukemia, each of which requires a different treatment approach. We use blood tests and a bone marrow exam to identify the type of leukemia affecting your child and determine if it’s related to a genetic change. Doctors also take a sample of spinal fluid to determine whether leukemia cells are in the central nervous system. This comprehensive evaluation allows us to design and personalize a treatment plan that offers your child the best possible results while minimizing the risk of long-term side effects. We will also work with you to create a follow-up plan for long-term cancer screening.
Your Child Benefits from Our Combined Expertise and Family-Centered Care
- Our leukemia specialists are also researchers who are dedicated to improving care for childhood cancer. They collaborate with pediatric cancer experts worldwide through the Children's Oncology Group, the world’s largest childhood and adolescent cancer research organization. That means your child benefits from the combined knowledge of leading cancer care experts and has access to the latest treatments, including stem cell transplantation.
- Your child’s cancer care team works collaboratively with pediatric specialists throughout Duke to address all areas of your child’s health that can be affected by leukemia and its treatment. Because leukemia affects the blood stream, your child’s care team may include expert guidance from specialists in heart care, neurology, hormonal disorders, reproductive health, and other areas. Together, we monitor your child’s health and manage his or her symptoms.
- During different phases of treatment, your child will need to spend time in the hospital. The amount of time and how often varies. Your child and your family will have a full range of support to help you. Our child life specialists are available to explain a procedure or offer fun activities to help your child pass the time. Our social workers and psychologists can offer support and guidance. And you can get a light meal, take a shower, or use the computer in our Ronald McDonald House Family Room. We do everything we can to make your time at the hospital a little more comfortable.
- Your child’s comfort is important to us. Our team focuses on managing symptoms and other aspects of treatment that affect your child’s quality of life. We help with pain management, supportive nutrition, relaxation techniques, and other approaches to help your child get through treatment as comfortably as possible.
Your child’s treatment may include one or more therapies, depending on their needs. Your child’s care team will explain all the treatment options and help prepare you and your child for what to expect during each phase of treatment.
All children with ALL and AML receive chemotherapy. The length of treatment varies for each type of leukemia. The goal of chemotherapy is to destroy cancer cells or stop them from growing, and preventing the cancer from coming back. Chemotherapy is given through an IV infusion, in a pill or liquid that is swallowed, or via an injection. In addition, all children who have chemotherapy as part of their care will receive some of their treatments injected directly into their spinal fluid, called intrathecal chemotherapy.
Some children with leukemia may require radiation treatment to the brain, spinal cord, or collections of leukemia cells outside the bone marrow (chloromas). External-beam radiation therapy, which is delivered by a machine outside the body, focuses high-energy radiation (X-ray) beams to kill or stop the growth of cancer cells. Our pediatric radiation oncologists use advanced imaging techniques to determine the exact location where radiation is needed to minimize damage to surrounding tissues
Some children with leukemia may need a stem cell transplant from an HLA-matched family donor, an HLA-matched unrelated donor, or cord blood.
Family and Support Services
We treat the whole child -- not just the disease. Your child receives a personalized treatment and follow-up plan that’s tailored to their needs. You have access to a variety of services that are designed to make your child’s experience as positive as possible and support your family throughout treatment.
We offer outpatient services -- such as chemotherapy, transfusions, and lab tests -- 12 hours a day, seven days a week at Duke Children’s Valvano Day Hospital. This means your child won’t need to be admitted to the hospital just because they feel ill or need treatment on a day when your doctor’s office is closed.
Teens and young adults are too old to be treated like young kids, but adult care might not be quite right for them either. Our Adolescent and Young Adult Program brings together the expertise of pediatric and adult cancer specialists to determine what’s best for each person, along with personalized psychological support. We customize treatment and services that consider your child’s unique needs, including support and guidance to help them cope with the impact of treatment on their high school or college activities and their social life.
Once treatment is complete, you can count on us for continuing support. We offer long-term follow-up services for preventive health care, including screenings and ongoing surveillance. Our cancer care doctors and nurses work with social workers and child psychologists who can offer support and assistance with school-related or personal issues. In addition, we can help your child transition to adult cancer care services when they’re ready. If your child needs other services related to treatment, we refer you to subspecialists. You’ll have resources and support to ensure your child’s long-term well-being.
It’s helpful to have a team on your side to help you manage your child’s care. Our social workers help you navigate the medical system and coordinate the variety of health services your child needs. They can help you work with insurance providers, connect you with resources, and help you manage the details related to your child’s care. Our nurse coordinators can help you schedule appointments for tests, treatments, and other medical visits.