VITAMIN D DEFICIENCY ALSO TRIGGERS LEUKEMIA

Associate Professor Müge Gökçe from the Pediatric Hematology and Oncology Department at Memorial Bahçelievler Hospital shared important information about the causes, symptoms and treatment methods of leukemia. Gökçe stated: "Leukemia, known among the public as blood cancer or bone marrow cancer, develops as a result of uncontrolled proliferation of white blood cells. Although it can be seen at any age, it is the most common type of cancer in childhood. Vitamin D deficiency, which plays a role in many organ systems in the body apart from bone development, can trigger leukemia as well as contributing to the development of many serious diseases." Although there is no known definitive cause of leukemia, the factors that increase the risk of developing leukemia are listed as follows:

• Down syndrome,
• Fanconi aplastic anemia,
• Genetic diseases such as Bloom syndrome,
• Exposure to high-dose radiation,
• Previous chemotherapy or radiotherapy for other reasons,
• Exposure to strong chemicals such as benzene,
• Maternal age being over 40 at pregnancy,
• Vitamin D deficiency.

Vitamin D is Critical from Birth

It is known that vitamin D deficiency prepares the ground for many serious diseases such as obesity, type 2 diabetes, metabolic syndrome, hypertension and cancer. In addition, recent studies have shown its relationship with leukemia. Due to low sun exposure, vitamin D deficiency is more common in people living in areas near polar regions, while vitamin D deficiency rates decrease as one approaches the equator. Studies show that childhood leukemias are found less frequently in equatorial countries. Based on this, vitamin D's role in childhood cancers began to be investigated. While vitamin D deficiency has been detected in many patients diagnosed with leukemia, the continuation of vitamin D deficiency also adversely affects treatment success. Additionally, laboratory studies have shown that vitamin D affects certain leukemia cells. Vitamin D deficiency alone does not cause leukemia, but in patients with risk factors, it can be a factor that may accelerate the process. To prevent vitamin D deficiency, vitamin D supplementation from the newborn period, adequate sun exposure, and regular consumption of vitamin D-rich foods such as milk, cheese, eggs and fish are recommended.

Pay Attention to Bone Pain and Lymph Nodes

There are 2 types of leukemia: acute and chronic. The most common type in childhood is acute lymphoblastic leukemia. Fever, pallor, weakness, fatigue, bruising on the body, repeated unexplained nosebleeds and gum bleeding, particularly bone pain resistant to painkillers, and lymph nodes in the neck can be signs of leukemia. When children have one or several of these symptoms, it is important to take them to a pediatrician without delay. However, these findings are not exclusive to leukemia. For example, bone pain can occur during growth periods. However, growth pain does not wake children from sleep at night like leukemia does and can be controlled with painkillers in a short time. Lymph nodes in the neck can also appear in some infections. However, if there are lymph nodes in the neck that do not shrink with antibiotic treatment or are gradually enlarging, it is essential to consult a pediatric hematology specialist.

Babies Under 1 Year Old Are Particularly at Risk

Leukemia, unlike lymphoma or breast cancer, cannot be staged. However, based on age, response to chemotherapy and genetic analysis results, it is divided into 3 risk groups: low, intermediate and high risk. Being between 2-5 years of age at diagnosis is a favorable finding, while being under 1 year of age is a risk factor. Leukemia is suspected if anemia, low platelet count and elevated white blood cell count are found in routine blood count. The appearance of leukemic cells in peripheral blood count also supports leukemia. However, definitive diagnosis is always made with bone marrow aspiration. Bone marrow aspiration is a procedure performed under anesthesia, mildly painful and harmless to the child.

10-15 Percent of Leukemia Cases May Recur

Leukemia is treated with chemotherapy by adjusting drug doses according to the risk group. Low and intermediate risk patients are treated with chemotherapy alone. However, some high-risk patients are treated with chemotherapy and radiotherapy while others require bone marrow transplantation. The success rate of treatment in low-risk leukemias is 85-90%, in intermediate-risk leukemias 80-85% and in high-risk cases 75-80%. 10-15% of leukemia cases may recur. The timing of disease recurrence is important. For example, cases that recur while treatment is ongoing are at higher risk and bone marrow transplantation must be performed. After the treatment period of approximately 2 years is completed, patients are at risk for relapse until 5 years are completed. After 5 years are completed, the patient is considered cured.