Acute Lymphocytic Leukemia (ALL) is one of several types of cancer of the cells in the blood and bone marrow (the tissue in the center of bones which makes blood). ALL is a cancer where young, immature white blood cells reproduce in an uncontrolled manner. DNA normally controls how the cells grow and reproduce. In ALL, the DNA of these cells has a mutation that allows them to grow and reproduce at a very high rate. Instead of dying like a normal cell would, these cells live a particularly long time. Normal healthy blood cells which are usually produced in the bone marrow get crowded and no longer can reproduce normally. “Acute” in the name of the disease refers to the disease coming on and progressing very quickly. “Lymphocytic” refers to the type of blood cells which grow out of control in this disease, lymphocytes, a type of white blood cell. “Leukemia” refers to this being a cancer of white blood cells. ALL can affect adults and children, but has better prognosis in children. Risk factors for ALL include: previous cancer treatment, previous radiation, and genetic disorders (such as Down Syndrome), and having a brother or sister with ALL.
Infections, nosebleeds, gum bleeding, fever, loss of appetite, shortness of breath, weakness, fatigue, weight loss, lymph node swelling causing lumps in the body (neck, armpit, stomach or groin), bone paint, joint pain
The diagnosis of ALL is made by checking several tests. First, a blood sample is taken which can show too many white blood cells and or young, immature white blood cells that are not normally in the blood. This blood test can also show too few red blood cells or platelets (the other cells that come from the bone marrow). If a problem with the blood (like leukemia) is suspected, a procedure is done to look at the bone marrow called a bone marrow biopsy. The biopsy involves making a small hole in part of the hip bone to take out bone marrow cells. This procedure is used to diagnose the cancer and to follow how the bone marrow is doing with treatment. Your doctor or oncologist may want to do some additional testing like taking X-rays or CT scan pictures of the body to determine if and to where the cancer has spread. If there is concern that you may have some cancer in your brain, a lumbar puncture, or “spinal tap” may be performed to check for abnormal white blood cells in the fluid that surrounds the brain.
ALL can be treated with chemotherapy, specific targeted drug therapy, radiation therapy, and bone marrow transplant. For ALL, treatment is done in three phases: induction (first phase, to kill the cancerous cells), consolidation (second phase, to get rid of any remaining cells in the brain or spinal cord), and maintenance (third phase, to keep cancerous cells from growing). This treatment can go over the course of several years. Induction chemotherapy usually is done in a hospital because blood cell counts can fall very low and need to be closely monitored. The chemotherapy also causes white blood cell levels to fall very low which makes the patient prone to infections. If a person has involvement of the brain or spinal cord, some of these medications may be injected directly in to the spinal fluid. Targeted drug therapy is sometimes used for specific types of ALL if they have known genetic changes. Radiation therapy uses radiation from x-ray type beams to target and kill cancer cells in a specific location. When other treatments are not successful or are likely to not be successful, bone marrow transplant can be used to treat ALL. Chemotherapy or radiation is used to get rid of the cancerous cells in the bone marrow followed by returning other bone marrow cells to that marrow to create new, healthy bone marrow. The donor for the bone marrow can either be someone else or the patient’s own marrow if it is harvested in a time when their cancer is in remission.
