As the name suggests, acute lymphoblastic leukemia refers to an 'acute' cancer type that affects the bone marrow and the blood. 'Lymphoblastic' primarily refers to the development of cancer in lymphocytes, a type of white blood cell.
Acute leukemia spreads rapidly while creating immature or defective blood cells instead of normal-functioning, mature ones. Thus, it is advisable to start the treatment as soon as the diagnosis has been made.
This type of cancer is more common in kids, but it is also prevalent in adults. However, reports suggest that pediatric patients have higher survival rates when treated properly.
Leukemia is a type of blood cancer that is characterized by the abnormal production of blood cells. This type of cancer develops due to certain undesirable mutations that lead to abnormal cell division. Leukemia also affects the bone marrow’s ability to produce other blood cells, such as red blood cells (RBCs) and platelets.
Leukemia may be acute or chronic. Acute leukemia progresses rapidly and will need immediate medical attention. Chronic leukemia, on the other hand, progresses slowly, and doctors may recommend monitoring or surveillance for some time before recommending treatment.
Treatment for leukemia depends on a myriad of factors, such as the type of leukemia, its stage, the patient’s age and overall health condition, and the patient’s preferences.
Acute leukemia, or ALL, refers to an aggressive type of blood cancer that is associated with the abnormal production of white blood cells (WBCs).
ALL affects the bone marrow and blood. Acute leukemia spreads rather quickly, especially to the bloodstream and lymph nodes throughout the body. This type of blood cancer will often need immediate medical attention and prompt follow–up care.
Acute lymphoblastic leukemia is the most common type of leukemia among children. Children are mostly between the ages of 2 and 5 when they are diagnosed with this condition. However, acute lymphoblastic leukemia in adults is also prevalent, though not very common.
Acute leukemia initiates in the bone marrow's lymphocytes or white blood cells. The bone marrow can be defined as the fatty and soft tissue present inside the human body. The marrow consists of cells responsible for producing platelets and blood cells.
ALL affects the lymphocytes, white blood cells mainly responsible for helping the body fight against bacteria and viruses. Normally, white blood cells produced by the bone marrow are immature and mature into normal-functioning cells as per their cell cycle.
However, in those with acute lymphoblastic leukemia, the immature WBC cells, which are called lymphoblasts, never turn into normal ones. Instead, they spread rapidly in the bone marrow, overtaking the count of platelets and other blood cells. Then, these immature cells move quickly to the bloodstream and other body parts.
There are mainly two types of acute lymphoblastic leukemia, depending on the type of white blood cell involved.
B-cell acute lymphoblastic leukemia, or B-cell ALL, is one of the acute lymphoblastic leukemia types that results in defective white blood cells, also called B-cell lymphoblasts. These immature white blood cells occur in the bone marrow and the bloodstream.
Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) is a rare subtype of B-Cell ALL wherein the leukemia cells carry a genetic mutation known as the Philadelphia chromosome.
One of the subtypes of B-cell ALL, hyperdiploid ALL, is known to be one of the most widespread cytogenetic abnormalities found in kids. Hypodiploid ALL is a subtype of B-cell ALL that is associated with a chromosome abnormality that causes individuals to have 45 chromosomes or less. As per experts, hypodiploid ALL has a poor prognosis as compared to other standard acute lymphoblastic leukemia types.
BCR-ABL1-Like ALL is a new subtype of high-risk B-cell acute lymphoblastic leukemia. It is marked by genetic alterations in kinase signaling receptors.
T-cell acute lymphoblastic leukemia is a type of ALL that primarily affects the T-lymphocytes, which are a part of the immune system and have the role of destroying infected cells and releasing cytokines, which play an important role in immune system regulation.
Early T-cell Precursor (ETP) ALL is a subgroup of T-cell lymphoblastic leukemia that originates from cells that have just migrated from the bone marrow to the thymus.
Aberrant antigen expression is a phenomenon wherein the cell expresses a lineage marker that is not normally expressed by that particular cell type. In some cases of T-cell acute lymphoblastic leukemia (T-cell ALL), aberrant antigen expression can be observed. In the case of T-cell ALL, aberrant antigen expression may cause the cancerous T-cells to produce lineage markers that are specific to B-cells. In such cases, this particular trait may help medical oncologists plan treatment with targeted therapy.
Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) are the two most common types of acute leukemia. The distinction between these two types depends on the type of blood cell involved in the cancerous growth.
In AML, the production of red blood cells, platelets, and myeloblasts is affected, while in ALL leukemia, the production of white blood cells or lymphocytes is affected. AML is more prevalent in adults, whereas ALL is more prevalent in children.
Acute lymphoblastic leukemia, a cancer of the bone marrow and blood, is known to affect white blood cells, which help the body fight off infections. This cancer type spreads quickly and thus gets its name, “acute lymphoblastic leukemia.”
Thus, doctors often recommend keeping an eye on acute lymphoblastic leukemia symptoms, if any, for an early diagnosis. Remember, an early diagnosis implies timely treatment and an increase in survival rates.
Here are some of the most common acute leukemia symptoms that a person should keep an eye on and consult a doctor if any of them appear. These signs and symptoms of acute lymphoblastic leukemia should not be ignored and should be checked as soon as possible.
Anemia is one of the most common acute lymphoblastic leukemia symptoms. The bone marrow fails to produce sufficient red blood cells as it gets overcrowded with leukemia cells. Those suffering from anemia experience frequent tiredness and heart palpitations.
Frequent bleeding is one of the most common acute lymphocytic leukemia symptoms. Patients with ALL may have nosebleeds or heavy menstrual periods. This happens because ALL affects the bone marrow’s ability to produce platelets, which are responsible for clotting.
Chronic coughing is also one of the most common signs and symptoms of acute lymphoblastic leukemia. Since it is also one of the early signs of acute lymphoblastic leukemia, it should not be ignored.
Low red blood cell count, anemia, and low count of blood platelets caused by ALL lead to dizziness in some ALL patients.
One of the important acute leukemia symptoms is extreme tiredness as the bone marrow fails to produce red blood cells at optimum levels.
Bone pain caused by the overcrowding of abnormal cells in the bone marrow is also one of the most common acute lymphoblastic leukemia symptoms.
Bone pain caused by the overcrowding of abnormal cells in the bone marrow is also one of the most common acute lymphoblastic leukemia symptoms.
Those with acute lymphocytic leukemia symptoms may sometimes show non-specific signs in the form of recurrent fever or infections. Due to the abundance of abnormal white blood cells in the bone marrow, the patient may find it difficult to recover from infections.
Joint pain is also one of the signs of acute lymphoblastic leukemia, which is caused by the overcrowding of abnormal cells in the bone marrow. At times, these abnormal cells press on the nerves or joints and cause pain.
Loss of appetite is also one of the acute lymphoblastic leukemia symptoms. This is because ALL cells often accumulate in the spleen, causing it to enlarge. The enlarged spleen presses on the stomach, which, in turn, gives the brain a false sense of fullness. ALL patients may also lose their appetite because of stress, depression, and pain associated with the disease.
When ALL cells accumulate in the spleen, it leads to the enlargement of the organ. This, in turn, causes pain in the abdomen region. This is one of the lymphoblastic leukemia symptoms that is easily ignored. Any pain that lasts for more than two weeks should not be ignored.
Night sweats are common in ALL patients as the body is constantly trying to fight the disease.
With the loss of appetite due to the accumulation of leukemia cells in the liver, spleen, and kidney, ALL patients experience unintended weight loss.
The shortage of normal cells and the overgrowth of abnormal white blood cells can cause extreme weakness in ALL patients.
When ALL cells spread further to other body parts, the disease causes swelling in the lymph nodes, the glands responsible for capturing bacteria and viruses.
In patients with acute lymphoblastic leukemia, especially T-cell ALL, the cancerous cells can cause the enlargement of the thymus, which further presses on the trachea. This can cause difficulty breathing.
Here are some of the potential acute lymphoblastic leukemia causes that can increase one’s risk of developing ALL. The following may answer the question, “What causes acute lymphoblastic leukemia?”
Genetic factors, namely certain gene mutations, chromosomal abnormalities, and certain inherited genetic tendencies, can serve as one of the possible acute lymphoblastic leukemia causes in some cases.
Excessive exposure to hazardous radiation, petrochemicals, tobacco smoke, and certain chemotherapy drugs is identified as one of the possible ALL causes.
Having certain inherited genetic conditions, such as Down Syndrome, Bloom Syndrome, Fanconi anemia, and ataxia telangiectasia, can be a possible cause of acute lymphoblastic leukemia.
Compromised immunity and disorders related to immunity may also serve as possible ALL causes.
Certain viral infections, such as the human T-cell leukemia virus and Epstein-Barr virus, can lead to an increase in the risk of acute lymphoblastic leukemia.
It is advisable to see an oncologist if any of the above-mentioned acute leukemia symptoms are persistent and do not go away with medications. Also, most of the acute lymphoblastic leukemia symptoms are similar to those of the flu, which can cause confusion. Thus, if the symptoms do not improve rapidly, it is better to see an oncologist.
An early diagnosis of acute lymphoblastic leukemia goes a long way toward designing an appropriate treatment for this condition. It is important for patients not to ignore the different signs and symptoms of acute lymphoblastic leukemia.
The diagnosis of acute lymphoblastic leukemia is made using various tests. These tests help doctors arrive at a definitive diagnosis, determine the extent of the disease, and devise a treatment plan that is most suitable for the patient.
At HCG, acute lymphoblastic leukemia treatments are devised by a multidisciplinary care team. This team comprises specialists coming from multiple disciplines to thoroughly evaluate the case and then create a treatment plan that is tailor-made to the individual needs of the patient.
The following are commonly recommended tests for leukemia that can help in the accurate diagnosis of acute lymphoblastic leukemia.
If an individual is suspected to have ALL, the doctor may recommend a complete blood count (CBC) initially. This blood test is performed to check for the levels of different cells in the blood, which include red blood cells, platelets, and white blood cells. Patients with ALL often have high levels of immature white blood cells and low levels of red blood cells and platelets.
Cytogenetic testing is recommended to look for chromosomal abnormalities. This particular test helps diagnose acute lymphoblastic leukemia and devise an effective plan for acute leukemia treatment.
Polymerase chain reaction (PCR) is a form of test done with the patient's DNA sample. This test can find even the slightest changes in the genes and chromosomes, which cannot be seen under the microscope. The test is used to determine the specific gene changes associated with ALL.
A bone marrow test is one of the common tests recommended for the diagnosis of acute lymphoblastic leukemia. The bone marrow test for acute lymphoblastic leukemia often involves bone marrow aspiration and a bone marrow biopsy.
During the bone marrow aspiration, the doctor inserts a thin, hollow needle into the bone to get a small amount of liquid bone marrow. On the other hand, during a bone marrow biopsy, the doctor removes a small part of the bone and marrow with the help of a bigger needle. The samples collected are examined for the presence of cancer cells.
Imaging tests, namely MRI, X-rays, ultrasound, and PET-CT, are recommended to obtain clear pictures of the insides of the human body. These imaging tests are recommended to determine the extent of the disease's spread.
Acute lymphoblastic leukemia progresses rapidly and is often found to spread to the patient's brain and spinal cord. A lumbar puncture test is performed to check for the spreading of leukemia. During the test, a hollow, small needle is inserted between the lumbar bones of the spine to collect the spinal fluid. This fluid is examined for the presence of cancer cells.
The treatment of acute lymphoblastic leukemia is divided into different phases or stages. Each stage or phase may last from a few weeks to several months. ALL patients need to complete all phases of their treatment for better health outcomes.
Induction is the first phase of acute leukemia treatment. The main purpose of this treatment phase is to destroy and kill the maximum number of leukemia cells present in the blood and bone marrow.
Also, this ALL treatment is used to restore the production of normal blood cells. Doctors administer different chemotherapy drugs during this stage.
During this phase, the doctors see if the cancer is still present even after the first cycle of treatment. If the results are positive, the doctor will continue with the consolidation stage of treatment.
This phase of treatment aims at destroying any left-over leukemia cells to prevent the cancer from coming back.
During this stage, the bone marrow is given time for recovery while maintaining remission.
During this treatment phase, the doctor first evaluates the possibility of leukemia coming back and any genetic changes the patient may have. During this phase, the chemotherapy drugs are administered in higher doses as compared to other stages.
This last phase of treatment is designed to prevent any of the leukemia cells from regrowing. During this stage, acute lymphoblastic leukemia medication is given to the patient for many years, but in lower doses. This phase may last up to two years, and patients can carry on with their routine activities during this phase.
Here are the different acute leukemia treatments recommended to ALL patients based on the type of ALL, the extent of its spread, the patient’s age, and the patient’s overall health status. The following acute lymphoblastic leukemia treatments may be recommended alone or in combination based on the individual case parameters:
Chemotherapy uses drugs to kill and destroy cancerous cells. During the process, the drugs are either administered to the patient intravenously or orally.
Induction chemotherapy is the first line of acute leukemia treatment. This phase of treatment is designed to destroy the maximum number of leukemia cells.
Also, during this phase of treatment, specific drugs are administered to restore the white blood cell count. Once the blood count becomes normal, a biopsy may be conducted to check whether the patient has achieved complete remission.
Consolidation chemotherapy involves giving multiple intensive chemotherapy cycles to the patients for six to nine months. During this phase, the patient may be given platelet and red blood cell transfusions.
Once the patients complete their cycles of chemotherapy, they are given oral chemotherapy medications for an extra period of 18 to 24 months. Also, the patients are required to go for multiple tests while on chemotherapy medicines.
As ALL is known to recur in the spinal fluid, chemotherapy is injected directly into the fluid of the spinal column. This is done through a process where a needle is inserted between the lower back's vertebrae, and then chemotherapy drugs are infused directly into the spinal fluid. This is known as Central Nervous System (CNS) Prophylaxis.
Blood transfusions are not part of the leukemia treatment plan, but they are sometimes used to reduce cancer symptoms such as anemia, bleeding, bruising, etc.
Since ALL patients are often more susceptible to viral infections, they are often administered preventive medications such as Septra, Bactrim, and Acyclovir.
During ALL treatment, a permanent central venous line is placed to administer acute lymphoblastic leukemia medication and draw blood samples for tests.
Radiation therapy uses high-energy radiation beams, such as X-rays, to kill and destroy cancerous cells. Radiation therapy is often recommended by doctors if the cancer spreads to the central nervous system.
A bone marrow transplant is a consolidation therapy used to treat and manage recurrences. During this procedure, the patient gets leukemia-free bone marrow (stem cells) from a healthy individual (the donor).
Investigational therapies can be defined as a new line of treatment or drug that doctors are investigating under a clinical trial or study. These therapies are recommended for patients who have exhausted all treatment options.
Targeted therapies make use of drugs that specifically target the bio-components associated with cancer cells and cause cancer cells to grow. By specifically targeting cancer cells, targeted therapy minimizes damage to healthy tissues in the body.
Immunotherapy refers to the use of drugs to assist a patient's immune system in identifying cancerous cells and launching an attack against them in an effective manner.
The acute lymphoblastic leukemia medical procedure can be tedious and daunting. Thus, the patient needs complete support not only from the medical staff but also from the people around them.
Here are some coping and support tips for acute lymphocytic leukemia patients:
It is advised to get proper knowledge about cancer, its treatment, and the risks involved before moving forward with the procedure. The patient can always ask the doctor and can research different platforms for proper information. This helps the patient make informed health decisions.
The healthcare team for cancer consists of psycho-oncologists, onco-dietitians, child-life workers, rehabilitation therapists, chaplains, and social workers. These professionals are exclusively trained to build a strong support system for cancer patients. The patients must get comfortable leaning on their healthcare team, as this also contributes to better health outcomes.
There are multiple organizations that come up with special programs for kids diagnosed with cancer. These activities include summer camps, wish-granting programs, and support groups. Exploring these groups can aid in getting the required help from both professionals and other volunteers who support pediatric cancer patients.
It is important for patients to keep their family and friends in the loop and keep communicating with them about their appointments, medications, any setbacks in the treatment, test results, etc. Patients must let their family and friends know they need them around and that they need their help. This helps the people around cancer patients understand the right way to be there for them.
There is no known way to achieve complete acute lymphoblastic leukemia prevention, as we are not fully aware of the causes of this condition. However, we do know that ALL is more common among children between the ages of 2 and 5, progresses rapidly, and will require immediate medical attention.
That said, we have identified a few factors that can increase the risk of ALL and a few preventive measures that may help reduce the risk of this condition. Being aware of the different acute lymphoblastic leukemia risk factors can help in reducing one’s chances of developing ALL.
Learning about different acute lymphoblastic leukemia risk factors is important, as this helps reduce the risk of ALL and supports early detection. That said, it is important to note that not everyone with these risk factors is going to develop ALL; these factors only increase one’s chances of getting ALL.
Gender is one of the main acute lymphoblastic leukemia risk factors, as it is known to affect males more than females. Though the exact reason for this is not known, experts believe that it is due to hormonal differences and genetic aspects.
Age plays a major role when determining the high-risk factors for ALL leukemia. Acute lymphoblastic leukemia is commonly found in kids, though it is seen among adults as well. Kids who are between the ages of 2 and 5 are at the highest risk of getting this type of cancer.
Individuals suffering from blood disorders, such as anemia, are more likely to develop acute lymphoblastic leukemia.
Those who have a parent or sibling, especially a twin, diagnosed with ALL have a higher risk of developing the cancer.
Having certain congenital syndromes, such as Fanconi anemia, Down syndrome, Bloom syndrome, Blackfan-Diamond syndrome, and ataxia-telangiectasia, can increase one’s risk of developing ALL.
Many studies have shown an association between tobacco smoking and high-risk ALL leukemia.
Getting exposed to radiation for long intervals is a significant risk factor for acute leukemia.
Exposure to chemicals such as benzene or certain chemotherapy drugs is also one of the most important acute lymphoblastic leukemia risk factors.
Prolonged exposure to electromagnetic fields can increase one’s risk of developing acute lymphoblastic leukemia.
Previous cancer treatments increase the risk of developing acute lymphoblastic leukemia. The risk appears to be higher when chemotherapy and radiation are both used in the treatment.
Here are certain relevant acute lymphoblastic leukemia prevention measures that one can adopt to reduce the risk of developing cancer.
As tobacco consumption is considered a major risk factor for ALL, doctors advise avoiding tobacco smoking as a measure for possible leukemia prevention.
Maintaining a healthy body weight and making efforts to lose weight if required may also play an important role in possible leukemia prevention.
Staying physically active with regular exercises is also found to help lower the risk of developing ALL.
Many environmental pollutants, such as air pollution, are known to increase the risk for ALL. Minimizing exposure to environmental pollutants can contribute to possible acute lymphoblastic leukemia prevention.
There are no specific foods that can prevent ALL, but having a nutritious and balanced diet can surely contribute to possible acute lymphoblastic leukemia prevention. Also, it is important to ensure that the food ingredients used in day-to-day cooking are of good quality, free of harmful adulterants and heavy metals, and that the food is prepared in a hygienic environment.
Certain water pollutants can increase the risk of acute lymphoblastic leukemia. Thus, it is advised to drink only filtered water as an acute lymphoblastic leukemia prevention measure.
Having a strong immune system can help reduce one’s ALL risk. Staying up-to-date with vaccinations helps strengthen a person's immune system and lower the risk of acute lymphoblastic leukemia.
Exposure to UV rays can also increase the risk of developing acute lymphoblastic leukemia, so it is highly recommended to practice appropriate sun safety measures for high-risk ALL prevention.
Acute Lymphocytic leukemia, or ALL, is a cancer affecting the bone marrow and blood. This type of cancer spreads quite fast and is mostly found among kids as compared to adults. However, survival rates are relatively high among children as compared to adults. The common symptoms of cancer include fever, frequent infections, pale skin, gum bleeding, and breath shortness.
