Acute lymphoblastic leukemia (ALL) is a type of blood cancer. It is the least common type of leukemia in adults.
ALL is a type of leukemia that starts from white blood cells in the bone marrow, the soft inner part of bones. It develops from cells called lymphocytes, a type of white blood cell central to the immune system, or from lymphoblasts, an immature type of lymphocyte.
Acute lymphoblastic leukemia invades the blood and can spread throughout the body to other organs, such as the liver, spleen, and lymph nodes. But it does not normally produce tumors as do many types of cancer. It is an acute type of leukemia, which means it can progress quickly. Without treatment, it can be fatal within a few months.
The outlook for acute lymphoblastic leukemia depends on factors such as younger patients tend to have a better outlook, for example, your outlook is better if you have a lower white blood count when you're diagnosed. Whether or not you have a chromosome abnormality called the Philadelphia chromosome. Having it suggests a poorer prognosis, your response to chemotherapy. Your outlook is better if you have no evidence of leukemia four to five weeks after starting treatment.
For most people, the cause of ALL is unknown. For this reason, there is no known way to prevent it. However, there are a few known risk factors for this type of leukemia. This means these factors may increase your chances of getting acute lymphoblastic leukemia. But it is not yet known whether these risk factors are actual causes of the disease:
* Exposure to high levels of radiation to treat other types of cancer
* Exposure to certain chemicals such as benzene, a solvent used in oil refineries and other industries and present in cigarette smoke, certain cleaning products, detergents, and paint strippers
* Having an inherited genetic syndrome such as Down syndrome
* Being white
* Being male
ALL can cause a variety of symptoms. Some of these can be vague and not specific just to leukemia. They include fatigue, fever, and loss of appetite or weight and night sweats.
Many symptoms of ALL are the result of a shortage of normal blood cells. That's because leukemia cells crowd out these normal cells in the bone marrow.
Depending upon where leukemia cells are present, other symptoms may include:
* A full or swollen belly from leukemia cells in the liver or spleen
* Enlarged lymph nodes such as in the neck or groin, under arms, or above the collarbone
* Bone or joint pain
* Headache, trouble with balance, vomiting, seizures, or blurred vision if the cancer has spread to the brain
* Trouble breathing if spread has occurred in the chest.
ALL is really a group of related diseases, or subtypes. Therefore, your treatment options depend upon your subtype and other factors. You may have more than one type of treatment including chemotherapy.
A bone marrow transplant, which involves use of high doses of chemotherapy and possibly radiation followed by a transplant of bone-forming stem cells. Stem cells usually come from a donor. Or, less likely, they come from your own bone marrow or peripheral blood. If you cannot tolerate high doses of chemotherapy and radiation, lower doses may be used with a mini transplant.
Treatment occurs in two parts -- induction therapy and post-induction therapy.
The goal of induction therapy is to achieve remission by:
* Killing as many leukemia cells as possible
* Returning blood counts to normal
* Ridding the body of signs of disease for a long time
About eight or nine out of 10 adults achieve remission after treatments, but many relapse, which lowers the overall cure rate to 30% to 40%. So even with remission, post-induction therapy is needed to prevent relapse. It involves cycles of treatment over two to three years. Usually, the drugs are different than the drugs used in induction therapy. The goal is to completely rid the body of leukemia cells that have not been found by common blood or marrow tests.
