CHAPTER 2 Leukemia

The world breaks everyone
and afterward many are strong
at the broken places.
—Ernest Hemingway
A Farewell to Arms
THE WORD LEUKEMIA literally means “white blood.” Leukemia is the term used to
describe cancer of the blood-forming tissues known as bone marrow. This spongy
material fills the long bones in the body and produces blood cells. In leukemia, the
bone marrow creates an overabundance of abnormal young white cells (blasts). As
the bone marrow becomes packed with blasts, production of red cells (which carry
oxygen and nutrients to body tissues), neutrophils (which fight bacterial infections),
lymphocytes (which fight bacterial and viral infections) and platelets (which help
form clots to stop bleeding) slows and stops. This results in a low red blood cell
count (anemia), low neutrophils (neutropenia) and lymphocytes (lymphopenia) and
a low platelet count (thrombocytopenia).
This chapter first looks at the function and composition of blood. Then it examines
who gets leukemia, what the signs and symptoms are, how it is diagnosed, and how
doctors determine the prognosis. The current treatments for each type of leukemia
are outlined. The chapter ends with a discussion of how to talk with your child about
the disease.