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Re: Childhood ALL?
Jul 26, 2004
[QUOTE=cherichi]I sincerely hope that this post doesn't come across as insensitive or insulting, as I know a diagnosis of leukemia is a difficult time for anyone. I have a couple of questions about childhood ALL that I've found no one to answer for me...

If childhood ALL were left untreated, how would symptoms progress?
What would a hospital do for pain relief, for a patient who wants to live their remaining time at home?
How coherent would a patient be, when symptoms are getting near the worst?

The reason I ask is because I'm a writer. I'm writing a book in which one of the characters- a very intelligent 15 year old girl- is diagnosed with ALL. She feels that she's finished what she was meant to do and this is her time to pass on to the next life, and asks her parents to not demand that she be treated.

Again, I hope this inquiry didn't upset anyone. I just need some [I]honest [/I] answers, please? Any information on this particular topic would be [I]greatly[/I] appreciated.[/QUOTE]
Your post isn't upsetting at all!

First of all, ALL is the type of leukemia that is USUALLY seen in kids (CLL is normally seen in adults). Secondly it really isn't that hard to diagnose....a complete blood count is often all you need (plus/minus a bone marrow aspirate/core biopsy).

Third, the main complications with leukemia in kids is bleeding, fatigue, infections. As the disease progresses, children can often become confused and not know where they are, who they are, and have trouble recognizing people. They can even get somewhat agitated and lash out. There is often a lot of pain associated with leukemia due to the expansion of the bone marrow at certain sites (most notably the pelvis and femurs). This is treated usually with IV opioids like morphine and dilaudid. Kids are also prone to infection (because they're both immunosuppressed from the cancer itself as well as the chemo). Pneumonia is a common one and it can often do them in. A very serious complication with an ALL child on chemo is something called febrile neutropenia. While their lymphoid white cells are very high, the chemo can cause a certain subset of their cells--neutrophils--to become depleted. These cells are your first line protection against bacterial you can imagine that, if a patient has a fever and has low neutrophils (i.e. neutropenia), s/he can succumb to an infection if not treated right away.

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