Hematology

Using a physical exam, your child’s medical history and appropriate diagnostic blood disorder tests, our pediatric hematologists can determine if a blood disorder or blood cancer is present. Once a diagnosis is confirmed, our team develops a customized treatment plan based on your child’s specific needs.

Once a blood disorder diagnosis has been made, our pediatric hematology specialists will create a treatment plan based on your child’s condition, age, extent of symptoms and your preferences. Your child’s blood disorder treatment plan may include one or more of the following:

• Antibiotics (if an infection is causing symptoms)
• Blood transfusions
• Bone marrow transplant (for aplastic anemia)
• Catheters (used to make the involved vessels wider)
• Diet and lifestyle modifications
• Intravenous gamma globulin (IVGG, a protein containing many antibodies which also slows the destruction of platelets)
• Medications and/or discontinuing medications that may be causing the problem
• Plateletpheresis (procedure removing extra platelets from the blood)
• Phlebotomy (procedure removing blood from the body)
• Rh immune globulin (medication which helps prevent the spleen from destroying platelets)
• Steroids
• Surgical removal of the spleen or gallbladder
• Vitamin and mineral supplements

If your child has blood cancer, our multidisciplinary cancer care team will be with you and your family through every step of diagnosis, treatment, recovery and survivorship.

Childhood leukemia

Leukemia is a cancer of the white blood cells, but it can begin in other blood types as well. The most common type of leukemia is acute lymphoblastic leukemia (ALL). This type of leukemia is diagnosed in children between the ages of two and four, and begins in the white blood cells of the bone marrow. There are two other types of leukemia in children, which are acute myelogenous leukemia (AML) and hybrid or mixed lineage leukemia.

Leukemia can be either fast-growing (acute) or slow-growing (chronic). Nearly all leukemias found in children are acute. Chronic leukemias are far more commonly found in adults.

Causes of childhood leukemia

According to the American Cancer Society, the exact cause of leukemia in children and toddlers is unknown. Cancer that occurs in children is because of DNA changes or cell mutations.

DNA changes inside healthy bone marrow cause those cells to become leukemia cells. The DNA from one chromosome breaks off and attaches itself to a different chromosome, which leads to leukemia.

Pediatric leukemia treatments

For children with leukemia, treatment occurs in two stages. First, they undergo remission induction therapy, where initial treatment is performed with anticancer drugs to kill the leukemia cells. The second stage of treatment involves maintenance therapy, which is used to kill any remaining leukemia cells. If all leukemia cells are not removed, the cells left behind could grow and cause a relapse of cancer.

Treatment options that we offer for leukemia include:

• Chemotherapy — This type of therapy uses drugs to kill cancer cells, administered either by pill, injection or through a catheter.
• Radiation — Radiation therapy involves the use of radiation to shrink tumors and kill cancer cells. External radiation therapy is used to treat acute lymphoblastic leukemia. This type of treatment is typically used for leukemia that has potentially spread to the brain or spinal cord.
• Stem cell transplant with chemotherapy — This type of treatment is often used after ALL was previously treated, but has returned. A stem cell transplant involves removing immature blood cells from the blood or bone marrow of the patient or a donor. Then, stem cells are infused via the blood to restore blood cells.

Per the American Cancer Society, the five-year survival rate for children with ALL is 85 percent.

Pediatric lymphoma

We are equipped with highly-trained physicians who have access to the most advanced techniques to diagnose and treat both types of pediatric lymphoma — Hodgkin’s and non-Hodgkin’s lymphoma.

Hodgkin’s and non-Hodgkin’s lymphoma are cancers of the immune system, specifically of the lymphatic system. Hodgkin’s lymphoma causes white blood cells to grow and multiply in the lymph tissues throughout the body. Non-Hodgkin’s lymphoma varies and depends on the size and the shape and growth pattern of the cancer cells. Additionally, non-Hodgkin’s lymphomas found in children differ greatly from the type found in adults.

There are three main conditions that help physicians classify Hodgkin’s and non-Hodgkin’s lymphoma:

• If the abnormal Reed-Sternberg cell is not present, the cancer is classified as non-Hodgkin's lymphoma. There are more than 60 different types of non-Hodgkin's lymphoma.
• Hodgkin's lymphoma and non-Hodgkin's lymphoma are treated differently. This is why it is important to know what type of cancer cells appear under a microscope.
• According to the American Cancer Society, non-Hodgkin's lymphoma accounts for about five percent of all childhood cancers, while Hodgkin's lymphoma accounts for roughly three percent.

Pediatric lymphoma treatment

For children with non-Hodgkin's lymphoma, chemotherapy is the main type of treatment. Radiation therapy is rarely used for childhood non-Hodgkin's lymphomas.

For child and teen patients with Hodgkin's lymphoma, chemotherapy is also the most common type of treatment. Depending on the patient, radiation therapy can sometimes used as well. Radiation therapy can be effective for Hodgkin's lymphoma that has not spread, however, radiation can potentially disrupt the growth of bones and soft tissues in young children. For this reason and others, radiation is becoming a less common type of treatment for children with Hodgkin's lymphoma.