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Acute Lymphoblastic Leukemia

Authors:
  • Cynthia Johnson, MA
Publication Type:

Condition

Acute Lymphoblastic Leukemia

(Acute Lymphocytic Leukemia; ALL)

Definition

Acute lymphoblastic leukemia (ALL) is a cancer of a type of white blood cells called lymphocytes. These cells grow in the bone marrow and help the body fight infections. ALL happens when the bone marrow makes too many of these cells. This makes it hard for the cells to work as they should. It also makes it hard for other types of blood cells to develop.

White Blood Cells.

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Causes

It is not clear what causes ALL. It is likely a combination of genes and environment.

Risk Factors

ALL is more common in children 2 to 5 years old and adults 60 years of age or older.

Things that may raise the risk of ALL are:

Symptoms

ALL may cause:

  • Fever and night sweats
  • Tiredness, weakness, and pale skin
  • Bone or joint pain
  • Easy bruising or bleeding
  • Painless lumps in the neck, underarms, stomach, or groin
  • Problems breathing
  • Loss of hunger, weight loss
  • Stomach pain or feeling of fullness below the ribs

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor will check for swelling of the liver, spleen, or lymph nodes. The person may be referred to a specialist.

Tests will be done to look for abnormal cells. They include:

  • Blood tests—to look at cells and genes
  • Bone marrow aspiration and biopsy —to remove and test a sample of bone marrow

If cancer cells are found, other tests may be done to see if the cancer has spread. Tests may include:

Treatment

The goal of treatment is to kill cancer cells and return blood and bone marrow back to normal. The person is monitored closely during and after treatment. One or more of these methods may be used:

Prevention

There are no current guidelines for preventing ALL.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It is given by pill, injection, or IV. The drugs enter the bloodstream and travel through the body. It kills mostly cancer cells, but also some healthy cells.

Drugs may also be injected into the fluid in the spinal column. They are used to kill cancer cells that spread to the brain and spinal column. This is called intrathecal therapy.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It is given by pill, injection, or IV. The drugs enter the bloodstream and travel through the body. It kills mostly cancer cells, but also some healthy cells.

Drugs may also be injected into the fluid in the spinal column. They are used to kill cancer cells that spread to the brain and spinal column. This is called intrathecal therapy.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. External radiation therapy directs radiation at the tumor from outside the body. It is used for ALL that may or has spread to the brain and spinal cord.

Stem Cell Transplant

Stem cells are immature blood cells. They are removed from a person's blood or bone marrow before treatment is done. They may also be taken from a healthy donor. A stem cell transplant puts the cells in the body after treatment. These cells can develop new, healthy cells.

Targeted Therapy and Immunotherapy

Targeted therapy uses drugs to attack parts of cancer cells. Some ALL cells have an abnormal chromosome that specific drugs can target and attack. These drugs are called tyrosine kinase inhibitors. They are used with chemotherapy.

Immunotherapy uses medicine to help the body’s immune system fight cancer. Monoclonal antibodies made in a lab may be used to attack a specific target, such as a protein on the surface of a cancer cell. Another type of therapy removes immune cells from a person's body. Changes are made to these cells in a lab. The cells are then put back in the blood so they can better fight cancer.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL) in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-lymphoblastic-leukemia-lymphoblastic-lymphoma-all-lbl-in-adults.
  • Acute lymphocytic leukemia (ALL) in adults. American Cancer Society website. Available at: https://www.cancer.org/cancer/acute-lymphocytic-leukemia.html.
  • Aldoss I, Stein AS. Advances in adult acute lymphoblastic leukemia therapy. Leuk Lymphoma. 2018;59(5):1033-1050.
  • General information about adult acute lymphoblastic leukemia. National Cancer Institute website. Available at: https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq.
  • General information about childhood acute lymphoblastic leukemia. National Cancer Institute website. Available at: https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq.
  • Leukemia in children. American Cancer Society website. Available at: https://www.cancer.org/cancer/leukemia-in-children.html.

Contributors

  • Mohei Abouzied, MD, FACP
Last Updated:
2023-04-01

(C) Copyright 2023 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.