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Leukemia and Lymphoma

Every year, more than 10,000 children are diagnosed with cancer. Of those, nearly one in three cases are a form of leukemia, making it the most common childhood cancer. Another 1,700 children under 21 are diagnosed with lymphoma each year. At Cook Children's our goal is to reduce those numbers to zero.

Our highly respected team of pediatric hematologists and oncologists have extensive expertise in treating childhood leukemia and lymphoma, including:

Dr. Pacenta

CAR T-cell therapy

Dr. Holly Pacenta Cook Children’s hematologist/oncologist, Cellular Immunotherapy Program, introduces CAR T-cell therapy, a targeted treatment now available for patients with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL).

The pediatric oncologists and hematologists at Cook Children's are actively involved in research to find treat and ultimately bring an end to leukemia and lymphoma.

Dr. Heym with patient

Total Therapy Study XVII

Dr. Kenneth Heym Medical Director, Oncology Program, Cook Children's Medical Center, talks about our participation in a new Total Therapy XVII clinical research trial. This important investigational research is currently the best available targeted therapy for ALL and LLy cancers.

The Incredible Promise of Total Therapy XVII


What is leukemia?

Genetic risk factors are those that are part of our DNA. DNA is the substance that carries our genes, the instructions for nearly everything our cells do. Learn all about genetics.

Leukemia can be either fast growing (acute), or slower growing (chronic). Almost all leukemia in children is acute.

There are two main types of acute leukemia:

  • Acute lymphocytic leukemia (ALL), also called acute lymphoblastic leukemia, accounts for about 3 out of 4 cases of childhood leukemia. This leukemia starts from the lymphoid cells in the bone marrow.
  • Acute myelogenous leukemia (AML), also called acute myeloid leukemia, accounts for most of the remaining cases. This leukemia starts from the cells that form white blood cells (other than lymphocytes), red blood cells or platelets.

Chronic myeloid leukemia (CML) is rare in children but the incidence increases with age and is more commonly seen in teenagers and young adults. CML arises in bone marrow from myeloid cells.

Who gets leukemia?

While we don't know the exact cause of most leukemia cases, during the past few years scientists have made great progress in learning how certain changes in DNA can cause bone marrow stem cells to develop into leukemia.

Children with certain genetic conditions such as Li-Fraumeni syndrome, Down syndrome, Klinefelter syndrome and others have an increased risk of leukemia. Other genetic diseases that cause children to be born with an abnormal immune system may also increase their risk of getting leukemia.

Though some genetic factors increase the risk of childhood leukemia, most cases of leukemia are not linked to any known genetic causes. There may also be environmental factors that contribute to childhood leukemia. These may include:

  • Exposure to high levels of radiation such as X-rays or CT scans
  • Chemotherapy drugs
  • Exposure to chemicals and pesticides

What are the symptoms of leukemia?

The symptoms of leukemia are not always obvious. If you notice the following symptoms in your child it is wise to talk with your pediatrician about them:

  • Easily tires, is weak or dizzy
  • Pale or ashen skin
  • Shortness of breath, trouble breathing or an unexplained cough
  • A fever or infection that doesn't get better
  • Bleeds or bruises easily, the gums may bleed often when brushing the teeth, recurrent nosebleeds
  • Continual bone or joint pain
  • A swollen belly
  • Swollen lymph nodes on the sides of the neck, underarms or groin area
  • Headaches, seizures, vomiting
  • Non itchy rashes caused by bleeding under the skin

Testing and diagnosis

Please bring your child's medical records to your appointment. We will create a complete medical history of your child including any past illnesses, environmental and genetic risk factors, what symptoms your child has had, and how for long. Once the history has been taken, the doctor will determine which tests your child may need. Tests may include:

Leukemia treatment

Treatment will depend on your child's diagnosis, and is different for every patient. As part of the hematology and oncology team, you will be included in choosing the course of care that is right for your child. Treatment may include one or a combination of:


What is lymphoma?

Lymphoma is actually the name for many types of lymphatic cancers. Every year, nearly 2,200 children in the U.S. are diagnosed with a type of lymphoma cancer. These cancers start in the lymphocyte cells of the immune system and most often affect the lymph nodes and other lymph tissues like the tonsils or thymus. They can affect bone marrow and other organs. There are two main types of lymphoma:

  • Hodgkin's lymphoma is very rare in children younger than 5. Onset usually occurs in the teen years or young adulthood. Nodular sclerosis is the most common subtype of Hodgkin's seen in children. Two other subtypes are mixed cellularity and lymphocyte predominance; these are most common in younger children. The causes of Hodgkin's lymphomas are still unknown, but the Epstein-Barr virus appears to play a role in approximately half of all children diagnosed with these forms of cancer.
  • Non-Hodgkin's lymphomas include diffuse large B cell lymphoma, lymphoblastic lymphoma and anaplastic large cell lymphoma. Some of these cancers may be aggressive, fast growing, and behave very differently from the types found in adults. They are also more common in boys than girls.

What are the symptoms of lymphoma?

The most common symptoms are:

  • Enlarged lymphnodes, usually in the neck, above the collar bone or in the underarm or groin area. These nodes are usually painless.
  • Coughing or difficulty breathing
  • Unexplained fever
  • Night sweats
  • Abdominal swelling
  • Loss of appetite or weight loss

Testing and diagnosis

If your pediatrician suspects that your child has lymphoma or if your child has been diagnosed and you are seeking a second opinion, the team at Cook Children's is here and ready to put their expertise to work for you. Tests are determined by your child's symptoms and additional tests may be performed to assure the most accurate diagnosis for your child.

The tests offered at Cook Children's include:

Lymphoma treatment

Just as no two children are alike, no two cancers are exactly alike either. Once the results and diagnosis are in, the hematology and oncology team will create a personalized plan for your child. Depending on the diagnosis and stage of your child's cancer, that plan may include one or a combination of the following treatments:

Active leukemia & lymphoma research studies

We are here to help.

If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-4007.