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Complications of Leukemia

Approximately 2000 children, or 4 per 100 000 younger than 15 years of age, are diagnosed as having leukemia in the United States every year. Three quarters of these children have acute lymphoblastic leukemia; the remainder have acute nonlymphocytic or chronic leukemia. Before the development of modern chemotherapy, virtually all children having any kind of leukemia died within a few months of diagnosis. With the effective forms of therapy now available, however, long-term disease-free survival for children who have acute lymphoblastic leukemia has improved to approximately 60% to 70%. As a result, pediatricians are seeing more children in their practices who either are undergoing antileukemic therapy or are long-term survivors of the disease. To provide optimal care for these children, the pediatrician not only must be familiar with the pathophysiology and treatment of childhood leukemia, but also must be aware of those complications that may occur during and after therapy. This review focuses on common complications of childhood leukemia, particularly those associated with acute lymphoblastic leukemia.
 INFECTION
 Because children who have acute leukemia are immunocompromised due to both the disease and its treatment, they are at high risk for infection. The pediatrician caring for these children must be aware of common infectious complications and their management.