A child playing with her teddy bear on a hospital bed

Increase in number of children referred for stem cell transplantation

Over the last four years, the South African Bone Marrow Registry (SABMR) has seen a marked increase in the number of children being referred for stem cell transplantation as a result of blood disorders and childhood cancers. 

Of the more than 800 patients referred for stem cell transplantation since 2019, 35% have been under the age of 18 years.  

In light of World Cancer Day (4 February), the SABMR is encouraging parents to seek medical attention for any symptoms or ailments that persist in children, as early diagnosis is key in treating many childhood cancers. 

Deputy director for the SABMR, Jane Ward, says leukaemia followed by lymphoma are the most common cancers among children worldwide. According to the National Cancer Registry, half of the cases diagnosed in South Africa are children under 4 years of age.

The diagnosis of childhood cancer is somewhat challenging, as it often mimics symptoms related to other common communicable diseases. Ward says it is therefore important for parents to keep a close eye on any unusual ailments that do not go away on their own.

“Unlike adult cancers, childhood cancer is very difficult to prevent or screen for because of causative genetic and environmental factors that are less understood, but if it is detected early, most children can be treated successfully. The tragedy is that two-thirds of children with cancer never reach a specialist treatment centre in South Africa – and when they do, their cancer is often at an advanced stage.”

Survival rates of childhood cancers in low- and middle-income countries are generally far lower: approximately 20% compared to high-income countries where the survival rate is 80%. 

This was recently highlighted in the World Health Organization’s Global Initiative for Childhood Cancer, which was launched to improve cancer outcomes for children by attaining a survival rate of 60% by 2030. 

The overall survival rates of childhood cancer in South Africa remain low, when compared to international data. According to Ward, addressing the concern requires a comprehensive approach involving the government, healthcare providers, international organisations and other stakeholders.

She says among the key factors driving delayed diagnosis among SA children is the stigma and myths linked to cancer, especially among certain local and ethnic groups. “Misconceptions surrounding childhood cancer need to be debunked with earnest, as this delays the treatment of the child who can often be saved and live a full life. In many cultures, western medicine is still not trusted or the family is of the belief that they may be shunned, since the disease is not properly understood.”

Ward says greater awareness of the warning signs of childhood cancer can encourage earlier diagnosis and lead to improved outcomes.

Childhood cancers share general symptoms with other illnesses; however, if one or more of the following symptoms persist, medical assistance should be sought immediately:

1.  Acute lymphoblastic leukaemia

• Fatigue and weakness

• Frequent infections

• Pale skin (anaemia)

• Easy bruising and bleeding

• Swollen lymph nodes

• Bone and joint pain

• Loss of appetite and weight loss

• Enlarged liver or spleen

• Headaches, vomiting or visual changes (in cases where leukaemia spreads to the brain and spinal cord)

2.     Hodgkin’s lymphoma:

• Enlarged lymph nodes, typically in the neck, armpits or groin

• Unexplained fever

• Unexplained weight loss

• Night sweats

• Itchy skin

• Fatigue

• Loss of appetite

3.     Non-Hodgkin’s lymphoma:

NHL can present with symptoms similar to those of HL, including enlarged lymph nodes, fever, weight loss, night sweats, fatigue and itching. However, the specific symptoms can vary depending on the type and location of the lymphoma.

Ward says all three these cancers can be cured with successful stem cell transplants.

“We have seen first-hand success stories of children who are now cancer-free and go on to live healthy and fulfilling lives because they received a timeous diagnosis and the right treatment. If you suspect something may be amiss with your child’s health, talk to your healthcare practitioner or ask for a second opinion. Early detection is key to reducing not only childhood cancer rates but child mortality rates in the long run,” she encourages. 

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