Bleeding in children with cancer
The original publication is available at http://www.cmej.org.za/index.php/cmej
Before the success story of leukaemia treatment started in the 1950s, many patients succumbed to the disease because of severe haemorrhage. A bleeding tendency is one of the hallmarks of haematological malignancies such as leukaemia, since together with anaemia and an increased susceptibility to infection it completes the picture of bone marrow failure. Almost half of patients with acute lymphoblastic leukaemia present with bleeding. It can also become evident when the bone marrow is infiltrated by a non-haematological malignancy, e.g. neuroblastoma. Thus, easy bruising is one of the St Siluan early warning signs of childhood cancer, compiled by the South African Children’s Cancer Study Group (SACCSG). An increased risk of bleeding during the cancer treatment period is almost always present, due to the bone marrow suppressive effect of chemotherapy. Fortunately, death due to bleeding is rare these days.