What are the Childhood Cancers?

These are most of the Blood Cancers

Leukemias: Incidence rate: 3,000 per year

• ALL Acute Lymphoblastic Leukemia: Incidence Rate: 2,500 Accounts for approximately 80% of Leukemias. 5 year Survival Rates: infants- 62%, under 15 years at diagnosis- 88%, over 15 years at diagnosis- 50% Acute Lymphoblastic Leukemia, or ALL, is a fast growing cancer of the white blood cells. Lymphocytes are a type of white blood cell that the body uses to fight infections. The cancerous lymophocytic cells are abnormal, and cannot fight infections and crowd out the production of healthy white blood cells.
  • Hypodiploid ALL survival rate: 15-20%
• AML Acute Myeloid Leukemia: Incidence Rate: 450-600 per year. 5 year survival 40-58% ; 10 year survival 37-41% AML affects white blood cells. The leukemic cells over populate the bone marrow and can spread to the liver, spleen, skin and central nervous system.
  • Acute undifferentiated leukemia (AML, M0)
  • Acute granulocytic leukemia (AML, M1 or M2)
  • Acute promyelocytic leukemia (APL, M3) Incidence: 50 per year, Survival Rate: 75%
  • Acute myelomonocytic leukemia (AMML, M4)
  • Acute monoblastic leukemia (AMOL, M5
  • Acute erythroleukemia (AEL, M6)
  • Acute megakaryoblastic leukemia (AMKL, M7)           
• CML Chronic Myeloid Leukemia
• JMML Juvenile Myelomonocrytic Leukemia
• ABL Acute Bilineal Leukemia- a rare Leukemia expressing both lines of leukemia,(myeloid and lymphobalstic) Incidence Rate: 90 per year. Cure rate 12%

Lymphomas: (Cancers of the Lymph System) Incidence: 1,700 per year

The lymphatic system is the system of glands and vessels that transport the infection fighting white blood cells called lymphocytes.

• Non-Hodgkin's Lymphoma: Incidence Rate: 750-800 per year, Cure Rate 87% for children under 15 years, 76% for those 15 and older.
  • High Grade:
    • Lymphoblastic Lymphoma: 30% of childhood NHLs.
    • Small Noncleaved Cell Lymphoma 40-50% of all childhood NHLs
      • Burkitt's Lymphoma
      • Burkitt's-Like Lymphoma
  • Intermediate Grade:
    • FLCL Follicular Large-Cell Lymphoma
    • ALCL Anaplastic Large Cell Lymphoblastic Lymphoma 20-25% of childhood NHLs
    • Diffused Small Cleaved Cell Lymphoma
    • Mantle cell Lymphoma
    • Peripheral T-Cell Lymphoma
    • Immunoblastic diffuse large cell lymphoma
  • Low Grade:
    • Small Lymphohocytic Lymphoma
    • Follicular lymphoma
    • Mucosal-Associated Lymphoma Tissue
    • Marginal Zone Lymphoma
    • Cutaneous T-Cell Lymhpoma
• Hodgkin's Lymphoma Incidence Rate: 850-900 per year; Cure Rate: 90%
  • Nodular Lymphocyte Predominance (LP)
  • Classical Hodgkin Lymphoma
    • Lymphocytic Rich
    • Nodular Sclerosis (NP) Lymph nodes contain scar tissue in addition to reactive Lymphocytes and Ree/d-Sternberg cells
    • Mixed Cellularity (MC) Lymph nodes also contain inflammatory cells.

These are most of the Solid Tumors

Cancers of the Nervous System

• Neuroblastoma Incidence Rate: 800 per year, 5 year Survival Rate: 64%; 10 year Survival Rate: 51% Recurrence rate 50%, no known cure for recurrence. Neuroblastoma occurs in the sympathetic nervous system and most commonly begins in the tissues of the adrenal gland located in the abdomen. Neuroblastoma can be found in multiple locations at the time of diagnosis.
  • Ganglioneuroblastoma- a rare cancer that is halfway between benign and malignant.
• Brain Tumors: Incidence Rate: 3,000- 3,500 per year, (20% of pediatric cancers)
  • Gliomas-account for 75% of brain tumors in young children
    • Brain Stem Glioma. Incidence Rate: 350 per year. 5 year Survival Rate: 5%. Brain stem tumors are more common in children than they are in adults. Surgery is usually not possible in these tumors, and radiation and chemotherapy must be used.
    • Astrocytoma. Incidence Rate: 1,496 per year. Astrocytomas are the most common type of childhood glioma and favor the nervous system. They arise from brain cells called astrocytes, and typically occur in the cerebellum, a part of the brain that coordinates voluntary muscle movements and maintains posture, balance and equilibrium. They also occur in the thalamus or hypothalamus. The majority are low-grade and are curable by surgery, but 20% are high-grade and grow rapidly, spreading throughout the brain. Astrocytomas may also arise in the optic nerve, especially in children with neurofibromatosis.
    • Malignant Gliomas. Incidence Rate: 500 per year. These tumors, including the anaplastic astrocytomas and glioblastomas, can arise anywhere in the brain and are much more aggressive than astrocytomas. They are never cured by surgery alone and require combination therapy with radiation and chemotherapy.
• Ependymoma: Incidence Rate: 653. This type of tumor arises from the cells lining the ventricles in central nervous system tissues - the cerebrospinal fluid-filled cavities in the brain.
• Medulloblastomas: Incidence Rate: 580 per year; 5 year survival rate: diagnosis age 0-4= 62%, age 5-14= 80%; age 15-19= 64% Typically located in the cerebellum, fast growing, and highly malignant. They frequently spread, invading other parts of the central nervous system via the spinal fluid. Medulloblastomas account for the largest percentage of pediatric brain cancers.

Sarcomas (cancerous tumors of soft tissues or bones):

• Bone Tumors
  • Osteo Sarcoma: Incidence Rate: 650 per year. 5 year Survival Rate: 66% , 10 year; 50-60% (depending on age at diagnosis and staging). Most common type of bone cancer, occurs most commonly in the bones around the knee. Like other cancers, osteosarcoma can spread into nearby tissues. It can also spread to the lungs and to other bones.
  • Ewing's Sarcoma Family of Tumors: Incidence rate: 500 per year, (10-15% of bone cancers), 5 year Survival Rate s 50-75%; 10 year survival rate 50-65% Ewing Sarcoma is a family of bone tumors that involve bone and soft tissue; typically beginning in the middle of a bone, usually in the femur, upper arm, ribs, and pelvis. Metastatic disease can be found in the lungs, bone and bone marrow. Ewing's is generally a genetic accident whereby two chromosomes transpose. The Ewing's Family of tumors includes:
    • Ewing's tumor of bone, 5 year Survival Rate: 75%
    • Extraosseous Ewing (tumor that grows outside the bone)
    • Primitive neuroectodermal tumor, or peripheral neuroepithelioma,
    • Askin's tumor (PNET of the chest wall)
    • Pelvic Ewing's (in the hip), 10 year Survival Rate: 50% recurrence rate 50%, no known cure for recurrence.
• Soft tissue Sarcomas: Incidence rate: 900 per year
  • Fibrosarcoma
    • Neurofibrosarcoma- occurs in the cells surrounding the peripheral nerves.
  • Mesenchymoma
  • Synovial Sarcoma
  • Liposarcoma
  • Rhabdomyosarcoma Incidence 650 - 1000, 5 year Survival Rate: 46-64% (depending on age, site, subtype, and staging at diagnosis) This is a fast-growing, highly malignant tumor, which accounts for over half of the soft tissue sarcomas in children. Rhabdomyosarcoma cells resemble immature striated, (or skeletal), muscle cells.
    • Embryonal rhabdomyosarcoma. Most common type, usually found in children under 15 and in the head and neck region and genitourinary tract.
    • Botryoid type. A variant of the embryonal type; the tumor arises as a grape-like lesion in mucosal-lined hollow organs such as the vagina and urinary bladder.
    • Alveolar rhabdomyosarcoma. A more aggressive tumor which usually involves the muscles of the extremities or trunk. Survival rates on metastatic diagnosis are as low as 20%.