Childhood Leukemia Cure Rates Reach 80% as Treatment Options Expand

Pediatric cancer primarily refers to cancers occurring in children under 10 years old, with leukemia being the most common type. It accounts for one-third of all pediatric cancer patients. Since the cause of leukemia is unknown and prevention is not possible, early detection remains the best approach. Symptoms include anemia, susceptibility to infections, easy bruising, and frequent nosebleeds.

Parents often blame themselves when their child develops leukemia, but current evidence shows that environmental factors or lifestyle habits have little impact. While some debate exists over genetic factors, no clear cause has been identified in most patients.

Professor Lee Jae-wook of Seoul St. Mary's Hospital's Department of Pediatrics will appear on Seoul Economic TV's "Now, the Masters" at 9 p.m. on the 28th. Professor Lee, who has treated pediatric cancer patients for over 15 years and serves as director of the Pediatric Hematology-Oncology Center, said, "Pediatric cancer has higher cure rates than adult cancer. Even when treatment is difficult, patients must not lose hope."

Causes of Pediatric Leukemia Remain Largely Unknown

Leukemia is a blood cancer in which blood cells produced in bone marrow become cancerous and proliferate abnormally. It is broadly divided into acute and chronic types. Acute leukemia is further classified into acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).

While acute myeloid leukemia is more common in adults, acute lymphoblastic leukemia is overwhelmingly predominant in children. The types of pediatric cancers also differ from adult cancers. Stomach, liver, colorectal, and breast cancers common in adults rarely occur in children. Instead, pediatric cancers include leukemia, brain tumors, lymphoma, neuroblastoma, Wilms tumor, and rhabdomyosarcoma.

Pediatric leukemia primarily affects children under 10 years old. The most common question parents ask is, "Why did this happen to my child?" Professor Lee emphasized, "Cases caused by parental mistakes or living environment are extremely rare. Parents should not feel guilty because their child developed leukemia."

A Disease That Starts Like a Cold: Why Early Detection Is Difficult

Early symptoms of pediatric leukemia are often mistaken for a cold or simple fatigue. Warning signs parents should watch for include prolonged fever, fatigue and lethargy due to anemia, and frequent bruising, nosebleeds, or bleeding.

Professor Lee explained, "If bleeding becomes frequent due to decreased platelets and the child seems more tired than usual due to anemia, blood disorders should be suspected."

When leukemia is suspected, blood tests are performed first to check white blood cell, red blood cell, and platelet counts. If abnormalities are found, bone marrow examination confirms the diagnosis. Professor Lee said, "Blood cancers have already spread throughout the body at diagnosis, making early detection concepts difficult to apply. Most cases are diagnosed through tests after symptoms appear."

Systemic Chemotherapy Is the Core of Treatment

Pediatric leukemia treatment requires chemotherapy, not surgery. Since blood cancer is a systemic disease, surgery that removes only part of the tissue cannot provide a cure.

Acute lymphoblastic leukemia (ALL) typically requires about one year of intensive chemotherapy followed by approximately two years of maintenance therapy. Acute myeloid leukemia (AML) can be treated within one year. Professor Lee explained, "Children have fewer underlying conditions and better recovery ability, so they tolerate chemotherapy relatively better than adults."

When chemotherapy alone cannot achieve a cure, hematopoietic stem cell transplantation is necessary. Hematopoietic stem cells are the source cells in bone marrow that produce all blood cells including red blood cells, white blood cells, and platelets. The transplant involves eliminating diseased cells through intensive chemotherapy and radiation, then infusing healthy hematopoietic stem cells to create a new blood system. Professor Lee noted, "While the transplant itself involves injecting cells through an IV, managing potential complications afterward is very important."

Recently, CAR-T therapy, a type of immunotherapy, has expanded treatment options. CAR-T therapy involves extracting the patient's immune cells (T cells), genetically modifying and multiplying them, then reinfusing them to attack only cancer cells. The infused CAR-T cells selectively kill cancer cells without affecting healthy cells.

Professor Lee said, "CAR-T therapy is applied to pediatric leukemia patients who have relapsed multiple times. It provides a new weapon for patients who previously had almost no treatment options and is greatly helping treat patients for whom a cure was once difficult."

Pediatric Leukemia Cure Rates Rise to 60-80%

Treatment outcomes for pediatric leukemia have improved significantly. The cure rate for acute lymphoblastic leukemia exceeds 80%. The cure rate for acute myeloid leukemia is 60-70%. Professor Lee emphasized, "The biggest reason for improved outcomes is not just new drugs but the ability to provide customized treatment based on patient risk levels." He added, "The strategy of avoiding excessive chemotherapy for patients with good prognosis while applying more intensive treatment for those with poor prognosis has significantly improved overall outcomes."

However, relapse remains a concern. The relapse rate for acute lymphoblastic leukemia is over 20%. In cases of relapse, chemotherapy is often used to achieve remission again before proceeding with hematopoietic stem cell transplantation. Children cured through chemotherapy alone typically do not experience many long-term complications. Most can attend school and pursue careers, leading normal lives. However, those who received stem cell transplants may need long-term management for chronic graft-versus-host disease, endocrine complications, and potential secondary cancers.

Professor Lee said, "Pediatric cancer has higher cure rates than adult cancer. Although treatment is long and difficult, maintaining hope and persevering day by day is important." He added, "After getting through it, patients will eventually reach a cure."