Acute lymphocytic leukemia (ALL) is a fast-growing cancer of a type of white blood cells called lymphocytes. These cells are found in the bone marrow and other parts of the body.
See also: Leukemia
ALL; Acute childhood leukemia; Cancer - acute childhood leukemia (ALL); Leukemia - acute childhood (ALL)
Acute lymphocytic leukemia (ALL) occurs when the the body produces a large number of immature white blood cells, called lymphocytes. The cancer cells quickly grow and replace normal cells in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form blood cells. ALL prevents healthy blood cells from being made. Life-threatening symptoms can occur.
This type of leukemia usually affects children ages 3 - 7. It is the most common childhood acute leukemia. However, the cancer may also occur in adults.
Most of the time, there is no obvious cause. However, the following may play a role in the development of leukemia in general:
The following increase your risk for ALL:
Acute lymphocytic leukemia (ALL) makes you more likely to bleed and develop infections. Symptoms include:
Note: These symptoms can occur with other conditions. Talk to your doctor about the meaning of your specific symptoms.
A physical exam may reveal the following:
Blood tests may include:
Tests are also done to look for chromosome changes in the cells of some leukemias. Leukemias with certain types of chromosome changes have a poor outlook, while those with other types of genes can have a very good outlook. Having certain chromosome changes may determine what kind of treatment you receive.
The first goal of treatment is to get your blood counts back to normal. If this occurs and the bone marrow looks healthy under the microscope, the cancer is said to be in remission. After remission, you will need more treatment to be cured. This treatment can include more chemotherapy or a stem cell transplant from a donor.
Chemotherapy is the first treatment used to try and put you into remission.
If you have a low white blood cell count, you may need to be placed in a hospital room by yourself so you do not catch an infection from other people.
ALL may spread to the brain and spinal cord. Many chemotherapy drugs given through a vein cannot reach these areas. Therefore, you may also receive:
Your health care provider will decide which treatment you receive after you've gone into remission. The treatment will depend on several factors, including:
If you have more chemotherapy and your ALL relapses, then you will need a stem cell transplant.
Additional treatments depend on other symptoms. They may include:
Joining a support group where members share common experiences and problems may help ease the stress related to illness.
Most children with ALL can be cured. Children usually have a better outcome than adults.
The following patients tend to do better:
Patients whose leukemia spreads to the brain or spinal cord tend to have a worse outcome.
Call your health care provider if:
You may reduce your risk of ALL by avoiding contact with certain toxins, radiation, and chemicals.
Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. Lancet. 2008 Mar 22;371(9617):1030-43.
Pidala J, Djulbegovic B, Anasetti C, Kharfan-Dabaja M, Kumar A. Allogeneic hematopoietic cell transplantation for adult acute lymphoblastic leukemia (ALL) in first complete remission. Cochrane Database Syst Rev. 2011 Oct. 5:(10):CD008818.