With the government stepping up efforts to fight against chronic diseases in children, one of the most dangerous conditions to watch out for is leukemia.

Protais Munyarugamba of Harmony Clinic describes leukemia as a malignant progressive condition in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leucocytes (white blood cells). These suppress the production of normal blood cells, leading to anaemia and other symptoms.

"The exact cause of leukemia is unknown, but it is said to be due to environmental and genetic factors,” he says.According to him, some of the risk factors include radiation, chemotherapy for some cancers, viral infections and exposure to some chemicals.

Due to abnormal proliferation of one type of blood cells, production of the other type of blood cells is suppressed. This leads to anaemia, bleeding from various body sites, weakness, fever, joint pains and increased risk of infection.

"Leukemia, also commonly known as blood cancer, takes the white blood cell lineage in the blood. It occurs in many forms and affects different ages, but the most common in children in Rwanda is called the acute lymphoblastic leukemia,” says Dr Achille Manirakiza, a clinical oncologist.

He notes that there are many risks attributed to acute lymphoblastic leukemia and several other genetic diseases associated with it, for instance, Down’s syndrome.

Manirakiza adds that exposure to radiation at an early age is a major risk factor. A twin developing leukemia within their first year of life confers to the other twin an increased risk of getting the disease too. And, of course, some cancer drugs that are used for other cancer conditions might expose the child to a higher risk of getting leukemia, he explains.

Manirakiza explains that the disease becomes a cancer because the normal cell production in the blood centres gets disrupted leading to a new generation of immature and erratic cells being produced.

He adds, that just like many other cancers, its onset is always very silent and it can be detected when a child starts experiencing fevers and other infections.

Signs and symptoms

Janvier Rusizana, a general practitioner at La Nou Velle Clinic in Remera, says patients with leukemia most of the time suffer from many other infections.

"Patients always have persistent fever and infections that hardly respond to medication because they (patients) lack white blood cells that usually aid in fighting germs in the body,” he says.

When one has leukemia, they always have a low white blood cell count, thus making it hard for the body to fight against infections.

"An infected child, for instance, experiences a series of symptoms, including fatigue, bleeding from all around the body and fevers because the bone marrow (main blood producing centre) gets attacked with the numerous immature white blood cells that account for leukemia,” explains Rusizana.

Other symptoms include loss of appetite and weight, headache, concentration lapses, vomiting, blurred vision, as well as swelling of the lymph nodes under the skin in some parts of the body, including in neck and underarm areas.

However, Rusizana points out recurrence of anaemia as a sign that someone could be suffering from leukemia.

"In children, there are more malignant tumors than in adults. People with leukemia will sometimes feel weak, dizzy, develop skin paleness, as well as experience breathing difficulties often,” explains Rusizana.

Treatment and prevention

Gonzalue Niyigaba, a general practitioner at Polyclinique la Medicale in Remera, says leukemia is curable if treatment is administered earlier enough.

"Leukemia can be treated, especially from 1-9 years of age, it’s easy to get good cure rates. Patients who are younger or older than that have to be handled with caution and are considered high risk groups,” cautions Niyigaba.

Manirikaza says the bigger challenge is that people start with medical personnel who do not sometimes think of its possibility at first, and tend to wait until it shows other associated symptoms.

According to medics, chemotherapy is the most used form of treatment for leukemia and it works if done early enough.

They advise that if one has unexplained bleeding, fever and weight loss, leukemia should be considered as a possible cause.

Signs of chronic lymphoid leukemia include swollen lymph glands in any site of body or an enlarged spleen if it is chronic myeloid leukemia.

Diagnosis is by doing a blood cell count, which will show one type of cells abnormally elevated if one is affected. Bone marrow biopsy is a confirmatory test.

Prevention lies in a healthy life style, having natural foods and avoiding exposure to chemicals.