Review of Leukemia in Children

Leukemia is the most common cancer in children, accounting for approximately one-third of all pediatric cancers. This disease affects the blood-forming tissues, with leukemic cells first growing in the bone marrow, then entering the peripheral blood, and possibly spreading to various organs, including the skin. Acute leukemia’s clinical symptoms stem from the frequently rapid onset of bone marrow failure. The clinical presentation typically includes high fever, gastrointestinal and pulmonary symptoms, severe and worsening anorexia, muscle and joint pain, and bleeding. This review explores the incidence and general epidemiology of childhood leukemia, including risk-increasing syndromes; recognizes the clinical presentation and interpretation of blood counts; examines potential oncologic emergencies; describes prognostic factors and the importance of minimal residual disease in precursor B-lymphoblastic leukemia; highlights supportive care in treating acute myelogenous leukemia; and addresses long-term complications of modern childhood leukemia treatments. This narrative review discusses the evidence suggesting an in-utero origin of childhood acute leukemia, focusing on acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). It highlights the significant diagnostic presence of these acute leukemias among hematologic cancers, the investigations into prenatal leukemogenesis, and the literature on prenatal risk factors during gestation.