Childhood leukaemia, the most common cancer in children, accounts for about 30% of all paediatric cancers. Every year, almost 25,000 children in India are diagnosed with cancer, with nearly 9000 of them having leukaemia. It affects the blood and bone marrow, leading to abnormal white blood cell production. While much information is available, some lesser-known facts about its symptoms, causes, and treatment options remain unfamiliar to many.

Uncommon Symptoms of Childhood leukaemia

Most people recognize common symptoms like persistent fatigue, fever, and easy bruising, but there are some lesser-known signs that might be overlooked:

1. Changes in Eye Appearance

– Some children develop white or bluish spots in the eyes due to leukaemia-related eye involvement.
– Swelling around the eyes and sudden vision problems may also occur.

2. Prolonged Bone Pain Misdiagnosed as Growing Pains

– leukaemia cells can infiltrate bones, causing deep bone pain that parents often mistake for normal growth-related discomfort.
– If a child limps frequently or avoids walking, it could be a red flag.

3. Gum Swelling and Bleeding

– leukaemia can cause gingival hyperplasia (gum overgrowth) and frequent bleeding of the gums.
– This is often mistaken for poor dental hygiene or vitamin deficiencies.

4. Frequent Infections Without a Fever

– While recurrent fevers are a well-known sign, some children may experience constant low immunity without developing noticeable fevers.
– Persistent sinus infections or fungal infections unresponsive to antibiotics may indicate an issue with white blood cell function.

5. Abdominal Swelling Due to Organ Enlargement

– leukaemia can lead to swelling of the liver and spleen, causing the belly to appear bloated.
– It might be mistaken for dietary bloating or digestive issues.

Hidden Causes and Risk Factors of Childhood Leukemia

1. Prenatal and Early-Life Exposures

– Exposure to high levels of pesticides, benzene, or household chemicals during pregnancy has been linked to a higher risk.
– Some studies suggest maternal stress and infections during pregnancy could influence fetal immune development, increasing susceptibility.

2. Links to Gut Microbiome

– Researchers have found that imbalanced gut bacteria in early childhood may contribute to leukemia risk.
– Children raised in extremely sterile environments with low exposure to microbes may have underdeveloped immune systems, leading to abnormal immune responses.

3. The Role of Hidden Genetic Mutations

– While some genetic mutations are inherited, many leukemia-related mutations occur spontaneously in the womb and remain undetected until symptoms appear.
– Some children may carry mutations in the PAX5 gene or ETV6 gene, increasing their risk of leukemia without a family history.

4. High-Risk Environmental Factors

– Living near high-voltage power lines or prolonged exposure to electromagnetic radiation is being explored as a possible contributing factor.
– Certain artificial food dyes and preservatives are also being studied for their potential effects on cellular DNA.

Little-Known Facts About Treatment and Recovery

1. Some Forms of Childhood Leukemia Can Resolve Without Immediate Treatment

– A rare condition called Transient Abnormal Myelopoiesis (TAM) in newborns with Down syndrome mimics leukemia but often disappears without treatment.
– This has led researchers to explore natural immune mechanisms that might help combat leukemia in its early stages.

2. Immunotherapy May Replace Chemotherapy in the Future

– CAR-T cell therapy, a revolutionary treatment, uses the child’s own immune cells to fight leukemia and is showing promising results with fewer long-term side effects than chemotherapy.
– Some new trials are testing cancer vaccines that train the immune system to recognize leukemia cells early.

3. Chemo Brain Affects Children Differently

– Many childhood leukemia survivors experience ‘chemo brain,’ leading to cognitive difficulties, but brain plasticity in children allows better recovery than in adults.
– Cognitive therapy and omega-3 fatty acids are being studied for their role in improving brain function post-treatment.

4. Leukemia Cells Can “Hide” from Treatment

– Some leukemia cells evade chemotherapy by entering a sleep-like state within bone marrow niches.
– New treatments aim to ‘wake up’ these dormant cells before targeting them with drugs.

5. Survivors Have a Higher Risk of Second Cancers

– Childhood leukemia survivors have a 4-6 times higher risk of developing a secondary cancer later in life due to previous chemotherapy and radiation exposure.
– Long-term follow-ups and nutrient-rich diets are recommended to help mitigate this risk.

Final Thoughts

While childhood leukemia is a life-altering diagnosis, research continues to uncover hidden factors that influence its development, progression, and treatment. Parents and caregivers should remain vigilant about uncommon symptoms and seek early medical evaluation for persistent health issues. With the rapid advancement of targeted therapies and personalized medicine, the future holds hope for better survival rates and fewer long-term complications for young patients.