Acute Lymphocytic Leukemia (ALL)

Acute lymphocytic leukemia (ALL) is a cancer of the blood and bone marrow. In ALL, there’s an increase in a type of white blood cell (WBC) known as a lymphocyte. Because it’s an acute, or aggressive, form of cancer, it moves rapidly.

ALL is the most common childhood cancer. Children younger than age 5 have the highest risk. It can also occur in adults.

There are two main subtypes of ALL, B-cell ALL and T-cell ALL. Most types of ALL can be treated with a good chance of remission in children. Adults with ALL don’t have as high of a remission rate, but it’s steadily improving.

The National Cancer Institute (NCI) estimates 5,960 people in the United States will receive a diagnosis of ALL in 2018.

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Acute lymphocytic leukemia occurs when the DNA in cells of bone is being failure. These errors will cause healthy cells to stop growing and die. However, the infected cells will grow stronger, more division.

Currently, it is unclear why this DNA mutations lead to Acute lymphocytic leukemia. However, many doctors did research and found that most cases of Acute lymphocytic leukemia are not hereditary.

There are many factors that can make you increase the risk of acute leukemia lymphoma lines, including:

  • Used to have cancer treatment, especially when the patient has ever had chemotherapy or radiotherapy;
  • Radioactive infection;
  • Genetic disorders, such as Down syndrome;
  • Has siblings who used to have acute leukemia lymphoma lines.

Having ALL increases your chances of bleeding and developing infections. The symptoms and signs of ALL may also include:

  • paleness (pallor)
  • bleeding from the gums
  • a fever
  • bruises or purpura (bleeding within the skin)
  • petechiae (red or purple spots on the body)
  • lymphadenopathy (characterized by enlarged lymph nodes in the neck, under the arms, or in the groin region)
  • enlarged liver
  • enlarged spleen
  • bone pain
  • joint pain
  • weakness
  • fatigue
  • shortness of breath
  • testicular enlargement
  • cranial nerve palsies

Your doctor must complete a full physical exam and conduct blood and bone marrow tests to diagnose ALL. They’ll likely ask about bone pain, since it’s one of the first symptoms of ALL.

Here are some of the possible diagnostic tests you might need:

Blood tests

Your doctor may order a blood count. People who have ALL may have a blood count that shows low hemoglobin and a low platelet count. Their WBC count may or may not be increased.

A blood smear may show immature cells circulating in the blood, which are normally found in bone marrow.

Bone marrow aspiration

Bone marrow aspiration involves taking a sample of bone marrow from your pelvis or breastbone. It provides a way to test for increased growth in marrow tissue and reduced production of red blood cells.

It also allows your doctor to test for dysplasia. Dysplasia is an abnormal development of immature cells in the presence of leukocytosis (increased WBC count).

Imaging tests

A chest X-ray can allow your doctor to see if the mediastinum, or the middle partition of your chest, is widened.

A CT scan helps your doctor determine whether cancer has spread to your brain, spinal cord, or other parts of your body.

Other tests

A spinal tap is used to check if cancer cells have spread to your spinal fluid. An electrocardiogram (EKG) and echocardiogram of your heart may be performed to check left ventricular function.

Tests on serum urea and renal and liver function may also be done.

Treatment of ALL aims to bring your blood count back to normal. If this happens and your bone marrow looks normal under a microscope, your cancer is in remission.

Chemotherapy is used to treat this type of leukemia. For the first treatment, you may have to stay in the hospital for a few weeks. Later, you may be able to continue treatment as an outpatient.

In the event you have a low WBC count, you’ll most likely have to spend time in an isolation room. This ensures you’re protected from contagious diseases and other problems.

A bone marrow or stem cell transplant may be recommended if your leukemia doesn’t respond to chemotherapy. The transplanted marrow may be taken from a sibling who’s a complete match.

There’s no confirmed cause of ALL. However, you can avoid several risk factors for it, such as:

  • radiation exposure
  • chemical exposure
  • exposure to viral infections
  • cigarette smoking

prolonged exposure to diesel fuel, gasoline, pesticides, and electromagnetic fields.

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