Pediatric Hematology: Understanding Childhood Blood Disorders

Pediatric hematology is a specialty that focuses on blood disorders and related cancers in children. From anemia to rare blood cancers, hematologists ensure that children receive the best care. Pediatric hematology-oncology also addresses cancers such as leukemia, lymphoma, and other blood cancers in children. In this article, we explore several essential aspects of pediatric hematology. These aspects range from hematologic cancers, tests, treatments, and the benefits of healthcare in Turkey.

What is Pediatric Hematology?

Pediatric Hematology is dedicated to diagnosis, management, and treatment of blood disorders and childhood cancers. Unlike adult hematology, pediatric hematology requires specialized approaches that takes the child’s growth account. Children face a wide range of blood disorders, from common problems to more serious. Pediatric hematologists are specially trained to diagnose and treat these conditions with the utmost precision.

What Are the Most Common Pediatric Hematologic Cancers?

Leukemia

Leukemia is the most common cancer in children. It accounts for about one-third of all childhood cancers. It starts in the bone marrow, where blood cells are made. In leukemia, abnormal white blood cells grow uncontrollably over normal cells and disrupting blood functions. There are two main types of leukemia:

• Acute Lymphoblastic Leukemia (ALL): ALL is the most common leukemia in children, forming 75% of all pediatric leukemia cases. It affects lymphocytes, a type of white blood cell critical to the immune system. ALL progresses rapidly, but with early detection and modern treatments, children often achieve remission.
• Acute Myeloid Leukemia (AML): AML is still significant. It affects the myeloid cells that develop into different types of blood cells. AML is usually aggressive and can spread quickly. Therefore, it often requires intensive chemotherapy or stem cell transplants.

Each type of leukemia has unique subtypes based on the specific characteristics of the cancer cells. This influences the treatment approaches. Both ALL and AML require a tailored approach, often involving a mixture of:

• Chemotherapy
• Targeted therapies
• Bone marrow transplantation

Lymphoma

Lymphoma affects the lymphatic system, which plays a critical role in immune function. It can develop in the lymph nodes, spleen, or bone marrow. This affects the body’s ability to fight infection. Childhood lymphoma is divided into two main categories:

• Hodgkin’s Lymphoma (Hodgkin’s disease): Hodgkin’s lymphoma is relatively rare in children under the age of five, but becomes more common in older children and adolescents. It is often identified by the presence of Reed-Sternberg cells. It is a specific type of abnormal cell formed in the lymph nodes. Hodgkin’s lymphoma generally has a good prognosis, especially if it is detected early.
• Non-Hodgkin’s Lymphoma (NHL): NHL is more common in children than Hodgkin’s lymphoma and tends to grow quickly. It affects different types of lymphocytes and spreads beyond the lymph nodes to other organs. NHL in children often presents as one of several subtypes. It includes Burkitt’s lymphoma, diffuse large B-cell lymphoma and lymphoblastic lymphoma. Treatment usually includes aggressive chemotherapy and, in some cases, immunotherapy. Thus, the survival rates have improved in recent years.

Neuroblastoma

Although not technically a hematologic cancer, neuroblastoma often involves bone marrow and blood abnormalities. Therefore, pediatric hematologists play a role in treatment. Neuroblastoma arises from immature nerve cells and typically affects infants and young children. It often starts in the adrenal glands. However, it has the potential to spread to bones, lymph nodes, and other organs. Symptoms may include bone pain, fatigue, and a lump in the abdomen, neck, or chest. Treatment often includes surgery, chemotherapy, and, in advanced cases, stem cell transplantation.

Bone Marrow Cancers

Although rare, some bone marrow disorders and cancers are also classified within pediatric hematology:

• Myelodysplastic Syndrome (MDS): MDS is a condition in which the bone marrow produces defective blood cells. Although primarily seen in adults, some children can develop MDS. It can progress to leukemia over time. Treatment is often difficult and may include chemotherapy or bone marrow transplantation.
• Juvenile MyeloMonocytic Leukemia (JMML): JMML is an aggressive and rare leukemia type that primarily affects children younger than four. It affects myeloid and monocyte cells, which are types of white blood cells. Symptoms may include enlargement of the spleen and liver, rash, and fever. Treatment usually includes chemotherapy, and stem cell transplants may be needed for long-term remission.
• Chronic Myeloid Leukemia (CML): Although rare in children, CML is a leukemia type progressing slownly, affecting the myeloid cells. It is linked to a genetic mutation known as the Philadelphia chromosome. Treatment often includes targeted therapies to control the disease. Chemotherapy or bone marrow transplantation can also be applied in case needed.

What are the Pediatric Hematology Tests?

The diagnosis of pediatric hematological disorders requires a number of specialized tests. Blood tests are often the first step, providing essential information about cell counts and composition. A complete blood count (CBC) is one of the most important tests. It helps to identify abnormal levels of red or white blood cells and platelets. A high white blood cell may indicate leukemia, while a low hemoglobin may indicate anemia. Blood smears and reticulocyte counts also help hematologists assess the size, shape, and maturity of cells. It provides a deeper understanding of conditions such as hemolytic anemia or bone marrow disorders.

If the results indicate a deeper condition, a bone marrow aspiration or biopsy may be needed. These procedures allow doctors to examine the bone marrow more directly.  It assess cell production and detects abnormal growths or cancer cells. An aspiration involves removing fluid from the bone marrow. Biopsy on the other hand, involves removing a small piece of solid tissue. These tests provide vital information about blood cancers such as leukemia. They help specialists at Acıbadem Healthcare Group determine the most effective treatments for young patients.

Genetic testing has become essential in pediatric hematology in terms of detecting inherited blood disorders. It can be beneficial for the detection of chromosomal abnormalities, such as the Philadelphia chromosome.  Conditions such as sickle cell anemia or thalassemia require genetic testing. Acıbadem provides valuable insight into potential hereditary risks and treatment options for these genetic diseases.

MRI and CT scans assess the blood cancer spread, with MRIs evaluating bone marrow involvement without radiation. PET scans identify fast-growing cancer cells. Flow cytometry and coagulation tests diagnose immune and clotting issues.

These tests enable the pediatric hematology team at Acıbadem to customize treatments, offering comprehensive care for children with hematological disorders.

What Treatments Are Available in Pediatric Hematology?

The pediatric hematology treatment options offered by Acıbadem are individualized according to each child’s condition. These treatments are designed to meet the needs of children and support their healing process.

Chemotherapy and immunotherapy

Chemotherapy uses powerful drugs to destroy cancer cells like childhood leukaemia and lymphoma. However, healthy cells can also be affected by this treatment. There may also be side effects such as hair loss and tiredness. Pediatric oncology specialists at Acıbadem manage these side effects for children to get less damage. Immunotherapy targets cancer cells by boosting the body’s own immune system. Innovative methods such as CAR T-cell therapy have shown positive results in resistant cancers.

Acıbadem plays a pioneering role as the first center offering CAR T-cell therapy in Turkey. CAR T-cells are produced in the Acıbadem Labcell Cellular Therapy Laboratory. They are modified to target cancer cells by genetically modifying the patient’s own T-cells. This treatment, has a success rate up to 80% in hematological cancers. It can be used for treating acute lymphoblastic leukemia (ALL) and non-Hodgkin’s lymphoma (NHL). The treatment process takes approximately 4-6 weeks. The recovery period and follow-up treatment of the patients are carried out meticulously. Acıbadem provides medical service for many patients from all over the world. Therefore, it is recognized worldwide for its high standards and experience in CAR T-cell therapy.

Stem Cell Transplantation

Acıbadem Altunizade and Atakent Hospitals in Istanbul provide international standards for adult bone marrow transplants. On the other hand, centers in Altunizade and Adana offer specialized treatment for children.

The stem cell transplant types that Acıbadem provide are:

• Autologous (using the patient’s own cells)
• Allogeneic (using donor cells)
• Haploidentical (sibling incompatible)

With world-renown physicians and modern infrastructure, Acıbadem also provides comprehensive support in post-transplant follow-up processes.

Radiotherapy and targeted treatments

Radiotherapy is preferred when the cancer has spread to areas like the central nervous system. Methods such as new-generation proton therapy increase the effectiveness of treatment by sparing healthy tissue. Targeted therapy reduces side effects by targeting specific genetic mutations in cancer cells. Such therapies are particularly effective in children with chronic myeloid leukemia.

Blood transfusions and supportive care

Blood and platelet transfusions in anemia or hemophilia diseases, increase children’s energy and prevent bleeding. Acıbadem Healthcare Group provides supportive care according to the individual needs of each child:

• Therapies for pain management
• Nutritional support
• Management of side effects

These options in pediatric hematology increase the chances of recovery for children with blood disorders. With these services offered by Acıbadem, families are fully supported through this challenging process.

Pediatric Hematology in Turkey

Turkey has become a major destination for pediatric hematology and oncology care. With advanced facilities, experienced professionals, and excellent care, Turkiye offers quality care at accessible costs. Pediatric hematology centers in Turkey offers state-of-the-art technology and advanced treatment in global standards. There are other services provided to support international patients in language, logistic, and personalized treatment.

When Should I See a Healthcare Provider?

If your child has these symptoms it may be time to see a pediatric hematologist.

• Persistent fatigue
• Unexplained bruising or bleeding
• Swollen lymph nodes
• Frequent infections

Early detection and intervention are critical to the effective management of pediatric hematologic disorders. If there is a genetic inheritance of blood diseases, consider regular checkups for your child.

Why Acıbadem Healthcare Group for Treatment?

Acıbadem Healthcare Group is a leader in pediatric hematology and oncology, providing comprehensive, patient-centered care. Acıbadem’s experts ensure that each child receives personalized care at every stage of treatment. Families who choose Acıbadem benefit from this compassionate care and a supportive environment.

Pediatric Hematology is a field dedicated to fight for children with blood disorders and cancer. With advanced diagnosis and treatment, more and more children are surviving these conditions. Also, complex cancers are not the only focus in this field. Parents should not hesitate seeking support for the treatment of common blood diseases as well. For those suffering from hematological diseases, Acıbadem Healthcare Group offers hope to heal children worldwide.