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An Investigation into Childhood Leukaemia in Northampton

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About leukaemia 
2.1

What is leukaemia?

Leukaemia is a form of cancer.  It occurs when the body makes too many immature white blood cells. 
 
2.2

 What are the symptoms of leukaemia? 

The symptoms of leukaemia are: 
  • those of anaemia: 
    1. tiredness and lethargy 
    2. pallor 
    3. general malaise 
  • infections
  • bleeding and bruising
2.3

How common is leukaemia in children? 

Cancer tends to be a disease that occurs more often as we get older and all cancers, including leukaemia, are uncommon in children.  This is one of the reasons why people get worried when they know that several children have developed leukaemia in one area. 

Below are some facts about the incidence of childhood leukaemia: 

  • Leukaemia is the most frequent type of cancer in children (0-14 years).
  • About 1/3 of all cancers in children are due to leukaemia.
  • It occurs most commonly between the ages of 1-4.
  • Around 450 cases of childhood leukaemia occur in the UK each year. 
  • Out of every 1,000,000 children under 15 we would expect about 40 to get leukaemia in one year.
  • During the first 15 years of life about 1 in every 1,700 children will get leukaemia.
  • It is slightly more common in boys than in girls.
2.4

 What causes leukaemia? 

The cause of leukaemia is not known.  Leukaemia is known to be associated with certain risk factors including: 
  • smoking
  • exposure to high levels of ionising radiation (e.g. after the bomb in Hiroshima)
  • social class (childhood leukaemia appears to be more common in the higher social classes)
  • some drugs (e.g. chloramphenicol and some cytotoxic drugs used to treat cancer)
  • chemicals (e.g. very high levels of benzene vapour)
  • genetic abnormalities (e.g. Down's Syndrome)
Recent work that suggests that it is possible that childhood leukaemia may be associated with viral infections and may be influenced by rural isolation (it is more common in rural than in urban communities) and the migration of people who bring new patterns of infection to a stable community 1. 
 
Although leukaemia is known to be associated with these various risk factors most cases of leukaemia are not associated with any known risk factor.  "Most individual cases of childhood leukaemia cannot be explained on the basis of any specific risk factor." 2 
Professor Cartwright
Leukaemia Research Fund
 
Environmental risk factors that are associated with leukaemia will be discussed in more detail later in this report.
2.5

How is leukaemia treated?

Leukaemia is treated in several ways: 
  • combination chemotherapy (this is where several different drugs that kill cancer cells are given to a patient)
  • radiotherapy
  • bone marrow transplantation.  Bone marrow contains the cells that make blood for the body.  When patients are treated with very strong chemotherapy or radiotherapy it can kill off these blood-making cells.  Without these cells we die but they can be replaced by a bone marrow transplant.  Replacement bone marrow can come from another person (for example a brother or sister of the patient) or can be collected and saved from the patient prior to starting bone marrow damaging treatment.
2.6

What happens to children with leukaemia? 

Prior to 1970 most children with leukaemia died; now most children survive. As more children have been entered into clinical trials so the effectiveness of treatments has improved.  The five-year survival rate for those treated in 1971-3 was 37% but by 1980-2 this had risen to 66% 3.  This improvement has continued and five-year survival rates are now well over 70% 4.  It is predicted that survival will continue to improve.
 
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© Northamptonshire Health Authority, reproduced by kind permission of Dr Amanda Burls, Sen Reg in Public Health Medicine.

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