In some cases, even when a child has received optimal care, the leukemia cells will return. When the disease comes back, the leukemia is said to have relapsed. This can happen when the child is still receiving treatment or after completing therapy.
How is relapse detected?
Your child will sometimes experience symptoms if their leukemia relapses. For some children these may be similar to the symptoms they had when they were originally diagnosed. Doctors may also detect relapse during routine tests such as physical examination, follow-up blood counts or a lumbar puncture.
Prognosis for children when leukemia relapses
How well your child responds to treatment after they relapse depends on a variety of factors.
Leukemia subtype
Some leukemia subtypes, such as T-cell ALL or AML, are more difficult to treat than others. As a result, your child’s leukemia subtype determines how well they respond to therapy during relapse.
Prior therapy
Not all children receive the same treatment protocol during their first cycle of treatment. Depending on your child’s leukemia subtype and risk category, they may have received radiation therapy as well as a bone marrow transplant. Having had either or both of these treatments in addition to chemotherapy influences how well a child recovers from relapse.
The length of time from the initial diagnosis
Children who relapse within the first year of remission are more difficult to treat than those who relapse later in life. These children may not respond to treatment, which means the disease is now resistant.
Site of relapse
Children with ALL who relapse can develop leukemic cells in their bone marrow, CNS, or testes. Children who relapse in the central nervous system have a better survival rate than those who relapse in the marrow.
Treating relapsed leukemia
The first goal for most children who have relapsed leukemia is to try to get their disease back into remission. Often this is more difficult than it was at the time of initial diagnosis. It may include further chemotherapy, bone marrow transplantation, and/or experimental therapy. Your child’s treatment team will discuss the details of your child’s new treatment plan.
