← Back
After treatment and remission

Remission in a child

In childhood leukaemia, especially ALL, remission is reached in most cases. This topic explains what remission means, along with maintenance therapy, follow-up and a child’s return to everyday life.

Last updated: ~3 min read
Small shoes by a door to a garden.
Figure 1.A child returning to everyday life.

01Short answer

Remission means that after treatment no signs of leukaemia are found in blood and bone marrow tests and blood counts have recovered. The most common leukaemia in children — ALL — goes into remission in most cases with modern treatment; results in AML have also improved considerably. Remission does not mean treatment is over: in ALL, the intensive phases are usually followed by maintenance therapy lasting about two years — mostly medicines taken by mouth. During this time the child usually lives at home and can go to nursery or school, but regular blood tests and doctor visits continue. A measurable residual disease (MRD) test shows how deep the remission is (topic “Monitoring with the CBC”). After treatment is completely finished, check-ups continue: often at first, then less often. The risk of relapse is highest in the first years and falls over time. Then long-term follow-up begins (topic “A long-term guide for the family”): growth, hormones (topic “Growth and hormones”), the heart, learning, fertility (topic “Fertility after childhood treatment”) and other late effects are checked. For parents, remission is a time of both joy and worry — and that is normal. A child’s return to everyday life — play, friends and school (topic “Back to school”) — matters for their development; your doctor will say when and how it is safe.

02Simple explanation

Remission means no signs of leukaemia are found.

In ALL, maintenance therapy usually lasts about two years.

Check-ups continue after treatment.

Then comes long-term follow-up.

Returning to childhood matters for development.

03Scientific explanation

Remission: according to the NCI PDQ, most children with ALL reach remission after induction treatment.

Maintenance: the ACS and NCI describe a total ALL treatment length of about 2–3 years, with maintenance therapy after the intensive phases.

Follow-up: the ACS recommends regular visits and blood tests after treatment; the risk of relapse falls over time.

Late effects: COG guidelines recommend lifelong, risk-based follow-up for everyone treated in childhood.

04What happens in the body?

What is remission?

Tests show no signs of leukaemia and blood counts have recovered. It is an important stage of treatment.

A kite in a calm sky.
Figure 3.Hope and freedom — Remission in a child

Maintenance therapy

In ALL, after the intensive phases, treatment continues mostly with medicines by mouth. Only the doctor changes the doses.

Check-ups

Blood tests and visits are frequent at first, then less frequent. Bone marrow and MRD tests if needed.

Toy blocks and a calendar.
Figure 2.Follow-up in childhood.

Everyday life

Nursery, school, play and friends — with the doctor’s agreement. Hand hygiene and protection from infection continue.

Parents

Joy and worry can come together. Look after yourselves too and ask for support.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05After remission

Steps.

Remission — Remission.1RemissionRemission.
Maintenance — Maintenance therapy.2MaintenanceMaintenance therapy.
Follow-up — Regular follow-up.3Follow-upRegular follow-up.
Childhood — Back to childhood.4ChildhoodBack to childhood.
RemissionRemission is maintained.
Follow-upCheck-ups continue.
ChildhoodThe child returns to everyday life.

06Stages after remission (simplified, ALL)

StageWhat happens
Intensive treatmentReaching and consolidating remission
Maintenance therapyUsually about two years, medicines by mouth
After treatmentRegular check-ups
Long-term follow-upChecking for late effects

* Exact timings depend on the protocol and risk.

07Key terms

Remission
No signs of leukaemia found.
Maintenance therapy
Long treatment to keep remission.
MRD
Measurable residual disease.
Induction
The first treatment to reach remission.
Relapse
The illness coming back.
Late effect
A problem that appears years after treatment.

08Key points

  • Remission is an important stage.
  • Follow maintenance therapy exactly.
  • Don’t miss check-ups.
  • Give your child back everyday life.
  • Tell the doctor about symptoms.
  • Look after yourself too.

09Frequently asked questions

Does remission mean cured?

Remission is a very good result, but follow-up continues.

Why is maintenance therapy needed?

To lower the risk of relapse.

Can my child go to nursery?

Often yes; ask your doctor.

When should I worry?

If you see the signs in topic “Which changes to report”.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

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.

  1. Does remission mean cured?

  2. Why is maintenance therapy needed?

  3. Can my child go to nursery?

  4. When should I worry?

  5. Does this information replace medical advice?

My questions

12Sources

  1. American Cancer Society. After Treatment for Childhood Leukemia
  2. American Cancer Society. Follow-up Care After Treatment for Childhood Leukemia
  3. National Cancer Institute. Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)
  4. National Cancer Institute. Late Effects of Treatment for Childhood Cancer (PDQ®)
  5. Children's Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers
  6. National Cancer Institute (NCI). Follow-Up Medical Care
  7. National Cancer Institute (NCI). Cancer Survivorship
  8. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  9. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
  10. National Cancer Institute. Facing Forward: Life After Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
Last updated: ← Back to the list

Open the interactive site →