Acute Lymphocytic Leukemia

Acute lymphocytic leukemia (ALL), also known as acute lymphoblastic leukemia, is a blood cancer that starts in the bone marrow.

This form of leukemia progresses rapidly, resulting in the increased production of immature lymphocytes from the marrow.

ALL occurs most frequently in children under 15 years, but may occur at any age. Occurrence in adults is rare.

If not treated, ALL can be fatal as the cancer may spread to other organs in the body.

Treatment of ALL in children has a good prognosis.

Many symptoms of Acute lymphocytic leukemia resemble that of a flu and is hence difficult to diagnose.

The differentiating factor is the time taken for these symptoms to resolve. With a flu, the symptoms resolve soon, while they persist in ALL.

Some of the most common symptoms of ALL include:

• Fatigue and weakness
• Increased time of blood clotting
• Fever
• Weight loss
• Frequent infections
• Small red spots under the skin
• Swollen lymph nodes
• Shortness of breath or difficulty breathing
• Enlarged liver and spleen
• Headache and blurred vision
• Bone pain
• Bleeding gums

Some other conditions like anemia, leukopenia,  and thrombocytopenia coincide with the presence of the disease. These are considered the signs of ALL.

Main causes of Acute lymphocytic leukemia are Aberrations in the DNA of bone marrow cells, which result in uncontrolled and abnormal division of the cells.

The lymphocytes produced by the aberrant division are immature and these develop into lymphoblast cells. These immature cells cannot function properly and accumulate in blood.

The actual cause for DNA changes in bone marrow cells is not known. Although it is caused by DNA mutations, ALL is not inherited from parents.

Certain factors like previous cancer treatment, radiation exposure, genetic disorders, and having a sibling with ALL, increase the risk of developing this blood cancer. Children who have had treatment for any other form of cancer have a higher risk for ALL.

Certain genetic disorders like Down syndrome also are associated with increased chances of developing abnormal blood cells.

Common tests conducted to make a diagnosis of Acute lymphocytic leukemia are:

• Blood tests – complete blood count reveals higher levels of white blood cells with low levels of red blood cells and platelets. Blood tests also help to identify abnormal blood cells that indicate cancer.
• Bone marrow aspiration and biopsy – bone marrow aspiration is used to remove a fluid sample from the bone marrow. A biopsy is used to remove a small section of tissue from the marrow. Analysis of the samples help in diagnosing blood cancer.
• Spinal tap – a spinal tap or lumbar puncture is used to take a sample of cerebrospinal fluid to check for cancer cells.
• Imaging techniques – images of body parts help to identify the cause of symptoms and to diagnose infections. Imaging methods like a CT scan or MRI are commonly used for this purpose.
• Other tests like flow cytometry, cytochemistry and karyotyping help in identifying specific genes and proteins that are characteristics of ALL.

The different treatment options available for Acute lymphocytic leukemia include:

• Chemotherapy – this method uses medications to destroy cancer cells and to prevent the growth of abnormal cells. It can be given intravenously, orally, or in the form of an injection. The first phase of this is induction therapy in which the drug is given within 3-4 weeks of diagnosis. Induction therapy focuses on destroying cancer cells and resolving the symptoms. The second phase is remission consolidation or intensification therapy in which a combination of drugs is given to kill the remaining abnormal cells. In the third phase, remission maintenance therapy, treatment is continued to prevent the recurrence of ALL. A preventive treatment called central nervous system prophylaxis treatment is given to prevent the cancer from spreading to the brain and spinal cord.
• Targeted therapy – in this method, specific genes or proteins that induce cancer are targeted. It prevents the growth and spread of cancer cells. More and more molecular targets are now being tested for the control of cancer.
• Radiation therapy – a high energy X-ray is used to destroy cancer cells. Radiation is given over a period of time.
• Bone marrow transplant – the affected bone marrow is replaced by highly specialized cells that may develop into healthy bone marrow.

Alternative treatments are used to ease the symptoms of Acute lymphocytic leukemia, but a complete cure has not been achieved.

Acupuncture, aromatherapy, massages and relaxation exercises are commonly used as alternative treatments.

There are different ways to adapt your lifestyle in coping with Acute lymphocytic leukemia.

Treatment of ALL is a long process and often very intense.

Learning more about the disease helps to understand and cope better with the treatment.

Look out for more programs that specifically target children who are under treatment for cancer.

Getting support from family and friends for appointments, treatments and programs are also very helpful in coping with the disease.

A weakened immune system is the most common complication of Acute lymphocytic leukemia.

This makes the person more susceptible to infections, which in turn increases the chance of other complications.