Pediatric leukemia is the most common malignancy in childhood, with an incidence of 3-5/100,000, and is one of the leading causes of death in children. The incidence is higher in males than females and can develop in children of any age, with the highest incidence in children of preschool and school age.
Most childhood leukemias are acute lymphoblastic leukemias, the onset of which is usually acute, with obvious clinical symptoms usually appearing within a few days or two months, with fever, anemia, and bleeding being the three most common manifestations. Fever is often the first symptom, mostly manifesting as a low-grade fever, mainly due to the high metabolism of malignantly proliferating leukemia cells, but also due to secondary infections. The child can develop progressively worsening anemia, thus manifesting as pallor, low appetite, frequent weakness, and shortness of breath. Bleeding is also a common early symptom, manifesting as bleeding from the skin and mucous membranes, often as bleeding spots or petechiae, bleeding from the oral mucosa and nasal bleeding, as well as bleeding from the digestive tract and urinary tract. The reason for bleeding is that the bone marrow is infiltrated by leukocytes and the megakaryocytes are inhibited, resulting in a decrease in platelet production, as well as insufficient platelet function and abnormal coagulation, which leads to bleeding.
Therefore, when children have recurrent fever, anemia and bleeding symptoms, they must be highly alert to the possibility of leukemia, and it is very important to have active blood tests and bone marrow aspiration to help in the early diagnosis of the disease.