Treatment and the treatment process

Treatment in children

Leukemia is the most common cancer in children. The good news is that treating childhood leukemia is one of medicine’s greatest successes. This topic explains what is special about treatment in children.

Last updated: 14 October 2026~2 min read

A children’s hospital room at dusk with a star-shaped night light, a teddy bear on the bed and paper cranes by the window. — **Figure 1.**A children’s ward should feel as homely and calm as possible.

01Short answer

About 75–80% of childhood leukemias are ALL and about 15–20% are AML; chronic leukemias are rare. Treatment follows international protocols according to risk group. Childhood ALL usually takes 2–2.5 years: induction, consolidation, intensification and a long maintenance phase; protecting the central nervous system is essential. Childhood AML is treated with shorter but more intensive courses and sometimes a transplant. In high-income countries, long-term survival in childhood ALL reaches about 90%. Family-centred care, psychological support, continued schooling and long-term follow-up after treatment are an integral part of care.

02Simple explanation

Children are different. Children often tolerate intensive treatment better than adults.

Protocol. Treatment follows a precise international plan.

The family is part of the team. Parents share decisions and daily care.

Life goes on. Play, school and friends are kept up as much as possible.

03Scientific explanation

Risk stratification: age, initial white cell count, genetics (for example ETV6::RUNX1 and hyperdiploidy — favourable; KMT2A and BCR::ABL1 — high risk) and MRD after induction set treatment intensity (NCI).

Modern additions: TKIs in Ph+ ALL; blinatumomab has been added to first-line treatment of B-ALL in some protocols; at relapse, CAR-T (tisagenlecleucel) is approved for children and young people.

Late effects: anthracyclines can affect the heart, steroids the bones, and cranial radiotherapy (now rare) thinking and learning. This is why Children’s Oncology Group long-term follow-up guidelines are used.

04What happens in the body?

How to explain it to a child

Simple, honest words suited to the child’s age are recommended. Psychologists, play therapists and nurses can help with the conversation. Children are often more afraid of the unknown than of the truth.

Large and small hands forming a circle around a small glowing light on a dark background. — **Figure 2.**The family is at the centre of a child’s care.

Life in hospital

Children’s wards have play rooms, a hospital school and volunteers. Favourite toys and family photos make the room feel more like home.

After treatment

Children return to school, play sport and grow up. Regular follow-up over many years helps spot possible late effects on growth, the heart, hormones and learning in good time.

A young tree growing along a lit path through spring, summer and autumn. — **Figure 3.**After treatment, the child grows, goes to school and is followed up.

05The path of a child’s treatment

A simplified outline.

1CentreA paediatric team.

2ProtocolBy risk group.

3Everyday lifePlay and school.

4Long-term follow-upGrowth and health.

High successEspecially in ALL.

FamilyPart of the team.

Personal riskGenetics and MRD.

06Main types of leukemia in children and their treatment

Type	Share (approx.)	Treatment features
ALL	75–80%	2–2.5 years, CNS prevention
AML	15–20%	Short intensive courses; sometimes transplant
APL	Rare	ATRA and arsenic trioxide
CML	Very rare	TKIs; growth monitored
Infant leukemia (<1 year)	Rare	Special protocols
Leukemia with Down syndrome	A special group	Adapted doses

* Figures are approximate; your child’s doctor will give exact information.

07Key terms

Protocol: A detailed written treatment plan.
Paediatric oncology-haematology: The field treating blood cancers in children.
Risk group: A group that sets treatment intensity.
MRD: Measurable residual disease.
Late effect: A problem that may appear years after treatment.
Hospital school: Continued learning during treatment.

08Key points

Childhood leukemia often responds well to treatment.
A paediatric centre matters.
Treatment follows a protocol.
The family is at the centre of care.
School and play continue where possible.
Long-term follow-up is needed.

09Frequently asked questions

Can my child go to school?

Often yes during maintenance, with the doctor’s agreement and infection protection.

How do we tell brothers and sisters?

Simply and honestly; don’t leave them out — a psychologist can help.

Will my child have vaccinations?

Live vaccines are not given during treatment; a plan is made with the doctor afterwards.

Will my child be able to have children later?

In most cases yes; some treatments can affect fertility, so discuss this beforehand.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

Can my child go to school?
How do we tell brothers and sisters?
Will my child have vaccinations?
Will my child be able to have children later?

My questions

12Sources

National Cancer Institute (NCI). Childhood Acute Lymphoblastic Leukemia Treatment (PDQ) – Patient Version
American Cancer Society. Treating Leukemia in Children
World Health Organization. CureAll framework: WHO Global Initiative for Childhood Cancer
National Cancer Institute (NCI). Childhood Acute Myeloid Leukemia Treatment (PDQ) – Patient Version
American Cancer Society. Leukemia in Children
Children’s Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood Cancer
Cancer Research UK. Stem cell and bone marrow transplants
MedlinePlus (U.S. National Library of Medicine). Bone marrow transplant
NMDP. What is a Bone Marrow or Blood Stem Cell Transplant
Bone Marrow Transplantation, 2022. Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022

Medical disclaimerThis information is for educational purposes only and does not replace medical advice.

Last updated: 14 October 2026← Back to the list

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