Xiaowen, a 4-year-old Fujian girl, went to the doctor because of shoulder pain, knee pain, and high fever, and at first thought it was bronchitis, but she did not expect that it was acute lymphoblastic leukemia.
Source: Network
A father in the countryside of Huai'an, Jiangsu Province, after learning that his 8-year-old son Qiang Qiang was suffering from leukemia, finally refused to treat his son because he was afraid of spending millions of dollars.
Leukemia is a serious disease with the highest rate of appearance on the screen, and many people often have an illusion: it is a "terminal disease", and it may be impossible to cure people and money.
Is this really the case?
1. Leukemia is no longer a terminal illness!
We know that there are two types of leukemia.
One is acute leukemia, which has an acute onset and progresses very rapidly. Its leukemia cells are also a group of acutes, looking very "naïve", and have not yet grown up to come out of the "mixed society".
If left untreated, the onset of illness to death can be in just a few months.
The other is chronic leukemia, which has a slow onset and the cells of leukemia grow slightly more mature and "sensible". Even if you don't get treatment, you can live for many years.
It sounds like chronic leukemia rather than acute.
However, the vast majority of childhood leukemias are acute leukemia (95%), and chronic leukemia accounts for only 3% to 5%.
● Among them, acute leukemia is divided into acute lymphoblastic leukemia (75%) and acute myeloid leukemia (20%);
● Chronic leukemia is divided into chronic myelogenous leukemia (1% to 3%) and juvenile myelogenous leukemia (2%).
Thankfully, the current cure rate (remission for more than 5 years) of acute lymphoblastic leukemia can reach more than 70% to 80%, and it has been considered to be a malignant tumor that can achieve the goal of cure [1].
The overall cure rate of acute myeloid leukemia can reach about 50% to 70%. Among them, the cure rate of acute promyelocytic leukemia is more than 90%, and this leukemia can really be cured!
2. Are there really more and more children with leukemia?
On October 16, 2018, the official data released at a press conference held by the National Health Commission are as follows[1]:
The incidence of childhood leukemia (under 15 years of age) in mainland China is about 4 to 5/100,000. This incidence has been relatively stable in recent years, with no significant change.
If it is extended to under 18 years of age, there are about 15,000 new children per year, the average course of treatment per case is 2 to 3 years, and the total number of people under treatment is about 45,000 per year.
That said, the incidence of childhood leukemia did not increase. However, every year there are new onset, rehabilitation and a small number of refractory relapses, and the total number of people under treatment is basically stable.
Due to the progress of medical diagnosis technology and the attention of parents, more and more children have been diagnosed early.
3. Why can't childhood leukemia be detected in the first place?
In the early stages of the disease, the symptoms of childhood leukemia are often atypical, such as fever, anemia, bleeding gums or nosebleeds, joint pain, etc. As the disease progresses, some symptoms will gradually "show dew".
Arthralgia: the onset of symptoms is the most common in children with osteoarticular pain, and the rate of misdiagnosis is also higher. Many children are initially misdiagnosed as rheumatoid arthritis and growth pain.
Anemia: in areas with underdeveloped medical and health environments, children with leukemia who are only anemic with dizziness and fatigue are often misdiagnosed as nutritional anemia;
Fever: also the main symptom of leukemia, easily misdiagnosed as a cold or upper respiratory tract infection;
"Sepsis": fever with hepatosplenomegaly, elevated blood picture, mainly neutrophils, easy to misdiagnose as sepsis.
In fact, many children with leukemia, at the beginning are similar to Xiaoli, because the symptoms are commonplace, and did not attract attention, at first they were treated as other diseases, and they went to many hospitals before they were finally diagnosed.
In areas with less developed medical conditions, if only some antibiotics or hormones are prescribed as conventional antipyretic drugs, the condition of leukemia is often covered up, and the abuse of hormones will temporarily "improve" the symptoms, but delay the timing of early treatment.
Therefore, if the child is found to have the above discomfort, it is best to take the child to the large third-class hospital for further examination.
4. Is there a way to prevent childhood leukemia?
The American Cancer Society notes [2] that most adult and childhood leukemias do not have any known risk factors and are difficult to prevent.
Childhood leukemia is the result of a combination of genetic and environmental factors. For example, people with mutations in the tumor suppressor gene TP53 are more likely to develop leukemia under the same risk factors.
At present, only some high-risk factors can be avoided.
Stay away from high doses of ionizing radiation: As in the case of survivors of the Atomic Bombing in Japan, the incidence of leukemia is higher. Ionizing radiation in life is mainly X-rays and CT, but the dose is very low, and doing it once will basically have no effect. For safety reasons, pregnant women and children are advised to avoid radiation tests as much as possible and stay away from the radiation department of the hospital.
Avoid benzene exposure: less to the building materials market, decoration sites, gas stations, cigarette processing plants, etc.; ventilation for at least 6 months after the renovation of new houses (preferably 10 months) before moving in; families with pregnant women and children try to avoid insecticides and hair dyes.
丨 Note: When it comes to decoration pollution, the first thing that many people think of is formaldehyde. But there is currently no direct evidence that formaldehyde causes leukemia.
The "killer" that everyone should pay more attention to is benzene produced by paint. Multiple population surveys have shown that exposure to toluene and xylene increases the risk of acute myeloid leukemia [3].
Don't smoke in front of children, it's best to quit: cigarette smoke contains benzene and some other radioactive chemicals, and second-hand smoke also has a risk of leukemia. Quitting smoking is about saving one's own life and that of one's whole family.
bibliography
National Health Commission of the People's Republic of China. One of the materials distributed by the National Health Commission at the press conference on October 16, 2018: Management work materials for the treatment of childhood leukemia [EB/OL].http://www.nhc.gov.cn/zhuz/xwfb/201810/c90c2b2698ad40d2b1f1aa35ff991aa0.shtml,2018-10-16/2018-12-25.
[2] American Cancer Society (ASCO): What are the risk factors for childhood leukemia? [OL].
https://www.cancer.org/cancer/leukemia-in-children/causes-risks-prevention/risk-factors.html
[3] Straube S, Westphal G A, Hallier E. Comment on: Implications of latency period between benzene exposure and development of leukemia-a synopsis of literature. [J]. Chemico-biological interactions, 2010, 186(2):26-29.
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