Childhood Leukemia: A Parent's Guide to Symptoms, Causes, and What Treatment Looks Like
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Childhood leukemia is cancer of a child's blood or bone marrow, caused by gene changes in blood cells, and it is the most common childhood cancer. Acute lymphoblastic leukemia is the most common type. Symptoms include exhaustion, paleness, bone pain, unusual bruising and fevers. Most childhood leukemias are curable, though survivors may need lifelong follow-up care.
What the research says
According to PubMed:
Adding blinatumomab to chemotherapy improved outcomes in standard-risk B-cell ALL. In a phase 3 trial of 1,440 children with newly diagnosed standard-risk B-cell ALL and an average or higher risk of relapse, estimated 3-year disease-free survival was 96.0% with blinatumomab plus chemotherapy versus 87.9% with chemotherapy alone at a median follow-up of 2.5 years. The monitoring committee recommended stopping randomization early, and nonfatal sepsis and catheter-related infections were more common in the average-risk children who received blinatumomab (Gupta et al., N Engl J Med, 2025 [1]).
For a first relapse, blinatumomab beat chemotherapy as consolidation. A meta-analysis of four randomized trials (703 children, adolescents, and young adults) found improved disease-free survival (hazard ratio 0.59, 95% CI 0.42–0.81), improved overall survival (hazard ratio 0.57, 95% CI 0.43–0.76), and a lower cumulative incidence of relapse (hazard ratio 0.26, 95% CI 0.16–0.41) (da Silva et al., Clin Lymphoma Myeloma Leuk, 2025 [2]).
Survivors' hearts need long-term monitoring. A systematic review found that survivors of childhood ALL had significantly higher rates of diastolic dysfunction and congestive heart failure than matched controls, even though overall five-year survival now exceeds 90%; female sex, younger age at diagnosis, and a higher total anthracycline dose were linked to more cardiotoxicity (Johnson et al., Mol Cell Pediatr, 2025 [3]).
Study details are from PubMed abstracts.
What Is Childhood Leukemia?
Childhood leukemia is cancer in a child's blood or bone marrow. Bone marrow is the spongy tissue inside bones where the body makes most of its blood cells. When blood cells turn into cancer cells, the disease can cause symptoms like ongoing exhaustion, belly pain, and frequent infections.
It is the most common type of childhood cancer. About 4,000 children in the U.S. are diagnosed each year.
Term | What It Means |
|---|---|
Leukemia | Cancer of the blood or bone marrow |
Bone marrow | The tissue inside bones where blood cells are made |
Acute | Fast-growing |
Chronic | Slow-growing |
Remission | No signs or symptoms of cancer remain |
What Are the Types of Childhood Leukemia?
The most common leukemias in children are acute, which means fast-growing.
Type | How Common | Notes |
|---|---|---|
Acute lymphoblastic leukemia (ALL) | Affects 3 in 4 children with leukemia | Most common type |
Acute myeloid leukemia (AML) | Second most common type | Also fast-growing |
Chronic leukemias | Less often | Slow-growing forms |
Chemotherapy is the most common treatment for these cancers, and it cures most cases. Some children may also be able to access newer therapies through a clinical trial.
Learning that your child has blood cancer can leave you searching for answers. The good news is that most of these cancers are curable — though a child's outlook depends on their unique diagnosis.
What Are the Symptoms of Childhood Leukemia?
Early symptoms of childhood leukemia can be tough to spot because they are also common in many other childhood conditions. If any of the signs below seem to last a long time, parents should schedule an appointment with their child's pediatrician:
Symptom | What It Looks Like |
|---|---|
Extreme tiredness | Being extremely tired, weak or pale |
Belly pain | Belly pain or a swollen belly, especially on the left side where the spleen is |
Bone pain | A child may limp or not want to walk |
Bruising and bleeding | Bruising or bleeding more frequently than usual |
Fever | Fever, chills or heavy sweating |
Skin spots | Red, purple or brown spots beneath the skin — signs of bleeding |
Swollen lymph nodes | Swelling in the neck, armpit or groin |
Weight loss | Unexplained weight loss |
What Causes Childhood Leukemia?
Leukemia happens when there is a change — called a mutation — in the genes within a cell. Usually, these mutations affect white blood cells. The mutation prevents them from doing their regular job: fighting infections.
Here is how the disease progresses:
The abnormal cancer cells multiply out of control in the bone marrow.
The cancer cells crowd out healthy white blood cells, red blood cells and platelets.
Eventually, the cancer cells spill out of the bone marrow into the child's blood and/or lymph nodes.
From there, they can spread and cause more damage.
Researchers don't know what causes these mutations in the first place. But they have discovered specific gene changes that are common in childhood leukemia — and those discoveries have helped doctors design life-saving treatments.
What Increases a Child's Risk?
Having a genetic disorder may increase a child's risk of leukemia. Some disorders raise cancer risk in general; others may make it harder for the immune system to fight cancer cells.
Risk Factor | How It Raises Risk |
|---|---|
Ataxia-telangiectasia | Genetic disorder linked to higher cancer risk |
Bloom syndrome | Genetic disorder linked to higher cancer risk |
Down syndrome | Genetic disorder linked to higher cancer risk |
Fanconi anemia | Genetic disorder linked to higher cancer risk |
Li-Fraumeni syndrome | Genetic disorder linked to higher cancer risk |
Severe congenital neutropenia | Low infection-fighting cells weaken the immune system |
Shwachman-Diamond syndrome | Genetic disorder linked to higher cancer risk |
Wiskott-Aldrich syndrome | Genetic disorder linked to higher cancer risk |
Radiation exposure | External exposure factor |
Sibling with leukemia | Especially a twin who has leukemia |
Some extremely rare genetic disorders are also linked to increased risk.
How Is Childhood Leukemia Diagnosed?
Diagnosis begins with talking to the child's pediatrician about their symptoms. Parents should share as much information as they can — including when symptoms started and how severe they are. Families may meet with additional healthcare providers along the way, including a pediatric oncologist (a cancer specialist for children).
Test | What It Checks |
|---|---|
Physical exam | Swollen lymph nodes or an enlarged liver or spleen |
Blood tests | Abnormal blood cells |
Imaging scans | Signs of cancer inside the body |
Biopsies | Cancer cells in the bone marrow or lymph nodes |
Lumbar puncture | Cancer cells in the fluid surrounding the brain or spine |
Genetic tests | Common mutations found in childhood leukemia |
Most of these tests are simple and noninvasive. For procedures that involve removing tissue, the child is completely relaxed or asleep. The care team works to make the process as easy as possible for both the child and the family.
How Is Childhood Leukemia Treated?
Children with leukemia usually receive standard cancer treatments along with new cancer therapies. The goal is to provide the best cancer treatment with the least amount of side effects. The care team discusses all options so parents feel confident in their child's treatment plan.
Treatment | How It Works |
|---|---|
Chemotherapy | The most common treatment to kill cancer cells; given as an infusion (IV), a shot or a pill |
Radiation therapy | Rarely used alongside chemotherapy; often part of a stem cell transplant |
High-dose chemotherapy with stem cell transplant | Chemotherapy kills cancer cells; new stem cells (an early form of blood cells) replace them |
Targeted therapy | Targets cancer cells with specific gene changes |
Immunotherapy | Strengthens the immune system so it is better at fighting leukemia |
Palliative care | Helps manage treatment side effects; available no matter the prognosis (unlike end-of-life care) |
Clinical trials | Tests the safety and effectiveness of new treatments, such as newer immunotherapy |
What Does Recovery Look Like?
Most children receive treatment in cycles, with recovery periods between them. The treatment break reduces side effects.
Still, it may take a few years to finish treatment entirely, because treatment involves several parts:
First, the goal is to send the cancer into remission — no cancer signs or symptoms. This may take several cycles (rounds) of chemotherapy.
Even after remission, the child will likely need more treatment to kill cancer cells that may be hiding, helping prevent the cancer from coming back.
Parents should ask their child's care team what their specific treatment and recovery timeline will look like.
What Is the Outlook for a Child With Leukemia?
Most childhood leukemias are curable. With treatment, it is possible for a child to live cancer-free for the rest of their life — though much depends on the type of leukemia and the type of gene mutations involved. For example, some types are more likely to grow back. The healthcare provider can discuss this with the family.
The survival rates for childhood leukemia are excellent. About 86 out of every 100 children diagnosed are alive five years later. The five-year mark matters because most cancers that don't come back within five years don't come back at all.
Even so, there can be long-lasting effects that families will need to discuss with their child's provider. For example, survivors of childhood cancer may be at increased risk of developing a different kind of cancer in the future. Both the cancer itself and the treatment can raise the risk of conditions later in life.
The cancer care team works with families to build a cancer survivorship plan. It includes information about the diagnosis, the treatment, and the future care the child will need — and every provider the child sees in the future should know this information.
When Should Parents Seek Care?
Children receive ongoing care during and after treatment. In the meantime, parents should make sure they know what side effects to expect, and ask when they should contact their child's healthcare provider or seek emergency care.
When to call now: If a child has symptoms that last a long time — such as extreme tiredness, belly or bone pain, unusual bruising or bleeding, fevers, swollen lymph nodes, or unexplained weight loss — schedule an appointment with their pediatrician. During treatment, any severe or unexpected symptom should be reported to the care team right away.
How Can Parents Help Their Child?
As a child's primary support, it is important for parents to realize that they do not — and should not — face this alone. The child, the family and the care team will face this challenge together.
What is the bottom line on childhood leukemia?
Childhood leukemia is the most common type of childhood cancer, with about 4,000 children diagnosed in the U.S. each year. Early signs — exhaustion, belly or bone pain, unusual bruising, fevers, swollen lymph nodes — are easy to miss because they look like ordinary childhood illnesses. Any symptom that lasts a long time is worth a visit to the pediatrician. When leukemia is found, treatment usually combines chemotherapy with newer therapies, takes a few years of cycles, and cures most children: about 86 out of every 100 diagnosed are alive five years later. With a strong care team and a survivorship plan, children can go on to live full, cancer-free lives.
Frequently Asked Questions
What is childhood leukemia?
Childhood leukemia is cancer of a child's blood or bone marrow — the tissue inside bones where blood cells are made. It is the most common type of childhood cancer.
How common is childhood leukemia?
About 4,000 children in the U.S. are diagnosed each year.
What is the most common type of childhood leukemia?
Acute lymphoblastic leukemia (ALL), which affects 3 in 4 children with leukemia. Acute myeloid leukemia (AML) is the second most common type.
What does "acute" mean?
Acute means fast-growing. Less often, children develop slow-growing (chronic) forms of leukemia.
What causes childhood leukemia?
Childhood leukemia happens when there is a change, or mutation, in the genes within a cell — usually a white blood cell. The mutation stops the cell from doing its regular job of fighting infections.
Can anything be done to prevent childhood leukemia?
Researchers don't know what causes the mutations in the first place, so there is no known way to prevent it. The gene changes researchers have discovered have helped doctors design life-saving treatments.
What factors raise a child's risk of leukemia?
Certain genetic disorders (such as Down syndrome, Fanconi anemia, and Bloom syndrome), radiation exposure, and having a sibling — especially a twin — with leukemia.
What symptoms should parents watch for?
Extreme tiredness or paleness, belly pain or a swollen belly, bone pain, unusual bruising or bleeding, fevers or heavy sweating, red/purple/brown spots under the skin, swollen lymph nodes, and unexplained weight loss.
Are these symptoms always leukemia?
No. Early symptoms are tough to spot because they are common in other childhood conditions too. The key question is whether symptoms last a long time — if they do, see a pediatrician.
Why do children with leukemia get tired and pale?
The cancer cells crowd out healthy red blood cells, which carry oxygen, causing weakness and paleness.
Why do children with leukemia bruise easily?
The cancer cells crowd out platelets, which help blood clot — so bruising and bleeding happen more frequently.
Why do children with leukemia get frequent infections?
The mutations usually affect white blood cells, preventing them from doing their regular job of fighting infections.
What is a lumbar puncture and why is it needed?
A lumbar puncture checks for cancer cells in the fluid surrounding the child's brain or spine.
What is a pediatric oncologist?
A doctor who specializes in diagnosing and treating cancer in children. Families may meet one along the way.
What is the most common treatment for childhood leukemia?
Chemotherapy — drugs that kill cancer cells, given as an infusion (IV), a shot or a pill.
Are there newer treatments beyond chemotherapy?
Yes. Options include radiation therapy (rarely), high-dose chemotherapy with a stem cell transplant, targeted therapy, immunotherapy, and new treatments through clinical trials.
What is a stem cell transplant?
High-dose chemotherapy kills the cancer cells, and then new stem cells — an early form of blood cells — replace the cancer cells.
What is palliative care?
Care that helps a child manage cancer treatment side effects. Unlike end-of-life care, it is available no matter the child's prognosis.
How long does treatment last?
It may take a few years to finish treatment entirely. Treatment comes in cycles with recovery periods between them, and even after remission, more treatment is often needed to kill hiding cancer cells.
What does remission mean?
Remission means there are no cancer signs or symptoms left. Several cycles of chemotherapy may be needed to reach remission.
Can childhood leukemia come back?
It depends on the type of leukemia and the gene mutations involved — some types are more likely to grow back. Even after remission, additional treatment helps prevent the cancer from returning.
What are the survival rates for childhood leukemia?
Survival rates for childhood leukemia are excellent. About 86 out of every 100 children diagnosed are alive five years later. Most cancers that don't come back within five years don't come back at all.
What is a cancer survivorship plan?
A plan the care team develops with the family, covering the diagnosis, treatment, and future care the child will need. Every future provider should know this information.
Are there long-term effects of childhood leukemia treatment?
Yes. Survivors may be at increased risk of a different kind of cancer later in life, and both the cancer itself and the treatment can raise the risk of conditions in adulthood.
How can parents support their child?
By working closely with the care team. Parents should not face this challenge alone — the child, the family and the care team face it together.
Related Reading
References
Gupta S, Rau RE, Kairalla JA, et al. Blinatumomab in standard-risk B-cell acute lymphoblastic leukemia in children. N Engl J Med. 2025;392(9):875-891 (published online December 7, 2024). PMID 39651791. https://doi.org/10.1056/NEJMoa2411680
da Silva AMP, Filho LFC, Han ML, et al. Blinatumomab versus chemotherapy for post-induction consolidation in first relapse of B-cell acute lymphoblastic leukemia: a systematic review and meta-analysis of randomized clinical trials. Clin Lymphoma Myeloma Leuk. 2025;25(11):e899-e910.e1 (published online May 8, 2025). PMID 40436683. https://doi.org/10.1016/j.clml.2025.05.004
Johnson P, Whitney E, Evans C, Beam D. A systematic review of long-term cardiotoxic effects of treatment in survivors of childhood acute lymphoblastic leukemia. Mol Cell Pediatr. 2025;12(1):9 (published online July 4, 2025). PMID 40613956. https://doi.org/10.1186/s40348-025-00196-y
Cleveland Clinic. Childhood Leukemia. Cleveland Clinic. Last updated August 27, 2025. https://my.clevelandclinic.org/health/diseases/childhood-leukemia
National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program. Cancer Stat Facts: Childhood Leukemia (Ages 0–19). SEER (National Cancer Institute). Accessed October 14, 2026. https://seer.cancer.gov/statfacts/html/childleuk.html
Kourti M, Aivaliotis M, Hatzipantelis E. Proteomics in childhood acute lymphoblastic leukemia: challenges and opportunities. Diagnostics (Basel). 2023;13(17):2748. PMID 37685286. https://doi.org/10.3390/diagnostics13172748
Tseng S, Lee ME, Lin PC. A review of childhood acute myeloid leukemia: diagnosis and novel treatment. Pharmaceuticals (Basel). 2023;16(11):1614. PMID 38004478. https://doi.org/10.3390/ph16111614
PDQ Pediatric Treatment Editorial Board. Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®): Health Professional Version. In: PDQ Cancer Information Summaries. Bethesda (MD): National Cancer Institute (US); April 16, 2025. PMID: 26389206. https://pubmed.ncbi.nlm.nih.gov/26389206/
Medical disclaimer
This article is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the guidance of a physician or other qualified health provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking it because of something you read here. If a child shows symptoms that could mean the cancer is returning or causing new danger, contact their healthcare provider right away. In any emergency — such as trouble breathing, severe bleeding, or loss of consciousness — call your local emergency number (in the U.S., 911) or go to the nearest emergency room right away.
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