Acute lymphocytic leukemia (ALL)

Acute lymphocytic leukemia (ALL) is a fast-growing cancer in which the body produces a large number of immature white blood cells (lymphocytes). These cells are found in the blood, bone marrow, lymph nodes, spleen, and other organs.

ALL; Acute childhood leukemia; Cancer - acute childhood leukemia (ALL); Leukemia - acute childhood (ALL)

ALL makes up 80% of childhood acute leukemias. Most cases occur in children ages 3 - 7. The disease may also occur in adults.

In acute leukemia, cancerous cells multiply quickly and replace normal cells. Cancerous cells take over normal parts of the bone marrow, causing bone marrow failure. A person with ALL is more likely to bleed and have infections because there are fewer normal blood cells.

Most cases of ALL have no obvious cause. However, the following may play a role in the development of leukemia:

• Chromosome problems
• Radiation
• Some chemotherapy drugs
• Toxins such as benzene

Persons with Down syndrome or who have a brother or sister with leukemia are at increased risk for ALL.

• Bleeding gums
• Bone pain or tenderness
• Easy bruising
• Excessive or prolonged bleeding
• Fatigue
• Fever
• Joint pain
• Infection
• Menstrual irregularities
• Nosebleeds
• Paleness
• Palpitations
• Pinpoint red spots on the skin (petechiae)
• Shortness of breath (made worse by exercise)
• Swollen glands (lymphadenopathy)
• Swollen gums
• Unintentional weight loss

A physical exam may reveal the following:

• Bruising
• Enlarged liver and spleen
• Signs of bleeding (petechiae, purpura)

Blood tests may show the following:

• Abnormal white blood cell (WBC) count
• Low red blood cell count (anemia)
• Low platelet count (thrombocytopenia)

A bone marrow aspiration will show abnormal levels of certain cells.

ALL may also change the results of the following tests:

• B-cell leukemia/lymphoma panel
• T-lymphocyte count
• WBC differential

If you are diagnosed with ALL, genetic tests will be done to determine the specific type of ALL. Doctors can look for chromosome changes in the cells of some leukemias. Leukemias with certain types of chromosome changes have a poor outlook, while those with other types of genes can have a very good outlook. This may determine what kind of therapy is used to treat the ALL.

Patients can ease the stress of their illness by joining a support group where members share common experiences and problems.

See also: Cancer - support group

Children usually have a better outcome than adults. Most adults go into complete remission. Without treatment, a person with ALL can expect to live for only about 3 months.

• Bleeding
• Disseminated intravascular coagulation (DIC)
• Relapse of ALL
• Severe infection

Call your health care provider if:

• You develop ALL-like symptoms
• You have ALL and you have a persistent fever or other signs of infection

Because the cause is usually unknown, it is not possible to prevent most cases. You may reduce your risk of ALL by avoiding exposure to toxins, radiation, and chemicals.