Which of the following leukaemias is most common in children?

Appeared in: DSSSB 13 August 2024

Explanation

Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in childhood.
ALL accounts for approximately 77% of all leukemia cases in children younger than 15 years old.
The peak incidence of ALL occurs between 2 and 5 years of age.
It arises from the clonal proliferation of abnormal lymphoid progenitor cells, disrupting normal bone marrow function.

Option A: Chronic Lymphocytic Leukemia (CLL) is a disease that primarily affects older adults and is extremely rare in children.
Option B: Chronic Myeloid Leukemia (CML) is uncommon in the pediatric population, accounting for only about 2-3% of childhood leukemias.
Option C: Acute Myeloid Leukemia (AML) is the second most common type of leukemia in children, but it is significantly less common than ALL, accounting for about 11% of cases.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Epidemiology of Childhood Leukemia as background academic context rather than a clinical decision trigger.
Recognizing that ALL is the most common pediatric cancer is crucial for primary care providers and nurses for prompt suspicion and referral. Symptoms like fever, pallor, bruising, and bone pain should trigger a high index of suspicion for leukemia.
Nurses play a key role in supporting the family through the diagnostic process, which includes blood tests and bone marrow aspiration, and providing education about the disease and treatment plan.
What if the question asked for the most common leukemia in adults over 60? The answer would change. In older adults, Chronic Lymphocytic Leukemia (CLL) and Acute Myeloid Leukemia (AML) are the most common types.

How to Approach the Question

First, identify the core of the question: it's asking for the 'most common' type of leukemia in a specific population, 'children'.
This is a factual recall question based on epidemiology. Access your knowledge about the prevalence of different cancers.
Differentiate between acute and chronic leukemias. Acute leukemias are generally more common in children than chronic forms.
Compare the two acute options: Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML).
Recall that ALL is significantly more common in children than AML.
Therefore, select ALL as the correct answer.

Concept Tested & Keywords

QMsVt9LXGna_ZknRZnxXrA

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 619-621

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 897-899

E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 119-121

Practise the full DSSSB 13 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.