n WHAT CAUSES ALL? All cells in the body contain genetic material called chromosomes that help cells to reproduce. Normal cells in the body grow and then die in a controlled way. Leukemia occurs when a chromosome is damaged, resulting in immature, rapidly dividing cells that do not die. In ALL, we do not know what causes chromosomes to become damaged. Certain risk factors increase a person’s chance of developing ALL. However, just having a risk factor does not mean a person will get cancer, and some people who develop cancer do not have any risk factors. Possible risk factors for ALL include • exposure to radiation before birth • certain genetic disorders, such as Down syndrome • previous chemotherapy treatment or taking other medications that weaken the immune system • being born with certain immune-system problems. n WHAT ARE THE SIGNS AND SYMPTOMS OF LEUKEMIA? The signs and symptoms of leukemia are noticed when leukemia cells are growing out of control and overcrowding occurs in the bone marrow. Symptoms may be different depending on the type of cell the marrow is (or is not) able to produce. Common symptoms seen in children include • fever or unexplained infections • easy bruising, bleeding, and petechiae (flat, pinpoint-sized red or purple dots on the skin) • fatigue and general weakness • bone or joint pain (limping or refusal to walk) that may come and go • lumps (caused by swollen lymph nodes) often found in the neck, underarms, stomach, or groin • swollen belly because of an enlarged liver or spleen • decreased appetite/weight loss. n WHAT TESTS AND PROCEDURES WILL MY CHILD NEED? The symptoms of ALL, such as looking pale, infections, or bleeding, usually prompt a visit to the pediatrician. Leukemia often is suspected when there are abnormal findings on a blood test called the complete blood count (CBC) or if abnormalities are noticed during a physical exam. To confirm the diagnosis of leukemia, additional testing will be needed. Tests that may be done are listed below.
Bone Marrow Aspiration and Biopsy This test involves inserting a needle into the bone (often the hip bone) to remove a sample of the bone
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