Acute Lymphocytic Leukemia
ALL is a cancer in your blood and bone marrow that occurs when abnormal cells grow out of control. Read more about this disease in children and...
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Acute lymphocytic leukemia (ALL) is the most common childhood
cancer, although it can also occur in adults. ALL is a cancer of the blood and
bone marrow that occurs when abnormal cells in a part of your body begin to
grow out of control. ALL is caused by an increase in white blood cells called
lymphocytes. Because it’s an acute, or aggressive, form of cancer, it moves
rapidly. Most types of ALL can be treated with a good chance of remission in
children. However, adults with ALL don’t have as high of a remission rate as
According to the American
Cancer Society (ACS), about 6,050 new cases of ALL, 3,450 males and 2,600
females, were diagnosed in the United States in 2012. Another 1,440 deaths, 820
in males and 620 in females, from ALL were also reported. Although most cases
appeared in children, four out five deaths occurred in adults. Children younger
than age 5 were at a higher risk of developing ALL. However, children are
typically better than adults at tolerating aggressive treatment.
What Are the Symptoms of ALL?
Having ALL increases your chances of bleeding and developing
infections. The symptoms of ALL may include:
- paleness, or pallor
- bleeding from the gums
- a fever
- bruises, purpura, or bleeding within the skin
- petechiae, which are red or purple spots on the
- lymphadenopathy, which is characterized by enlarged
lymph nodes in the neck, under the arms, or in the groin region
- hepatomegaly, or enlargement of the liver
- splenomegaly, or enlargement of the spleen
- bone pain
- joint pain
- shortness of breath
- testicular enlargement
- cranial nerve palsies
What Are the Risk Factors for Acute Lymphocytic Leukemia?
The cause of ALL isn’t known, but a few risk factors have been
People who’ve been exposed to high levels of radiation, such as those
who’ve survived a nuclear reactor accident, have shown an increased risk for
ALL. According to this study,
Japanese survivors of the atomic bomb in World War II had an increased risk of
acute leukemia six to eight years after exposure.
Studies done in the 1950s showed that fetuses exposed to
radiation, such as X-rays, within the first months of development present an increased
risk for ALL, however, more recent studies have failed to replicate these
outcomes. Nevertheless, it’s still not recommended for pregnant women to
undergo X-ray imaging.
This study from the American Journal of
Epidemiology shows that prolonged exposure to chemicals like hair dyes,
benzene, and even chemotherapy drugs show a strong link to the development of
Indian Journal of Pathology and Microbiology reports that various viral
infections have been linked to an increased risk for ALL. T-cells are a
particular type of white blood cell. Infection with human T-cell leukemia
virus-1 (HTLV-1) can cause a rare type of T-cell ALL. Epstein-Barr virus, which
is usually responsible for infectious mononucleosis, has been linked to ALL and
ALL doesn’t appear to be an inherited disease, but some inherited
syndromes exist with genetic changes that raise the risk of ALL. These include:
- Down syndrome
- Klinefelter’s syndrome
- Fanconi’s anemia
- Bloom syndrome
People who have siblings with ALL are also at an increased risk
for the disease.
Race and Gender
African-Americans have shown a higher risk for ALL than
Caucasians, and men have a higher risk than women. The reasons for these
differences in risk aren’t well understood.
Other Risk Factors
The following have all been studied as possible links to ALL:
- cigarette smoking
- long exposure to diesel fuel
- electromagnetic fields
How Is Acute Lymphocytic Leukemia Diagnosed?
Your doctor must complete a full physical exam and conduct blood
and bone marrows tests to diagnose ALL. They’ll likely ask about bone pain,
which is one of the first symptoms of ALL. Some of the possible diagnostic
tests you might need include the following:
- 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, and their white blood cell count may or may not be increased.
- A blood film may show immature cells circulating
in the blood, which are normally found in bone marrow.
- Bone marrow aspiration involves taking a sample
of bone marrow from your pelvis or breastbone, and 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, which is an abnormal
development of immature cells, in the presence of leukocytosis, or increased
white blood cells.
- 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.
- A spinal tap is used to check if cancer cells
have spread to your spinal fluid.
- Tests on serum urea, renal, and liver
biochemistry may be done.
- An electrocardiogram and echocardiogram of your heart
may be performed to check left ventricular function.
How Is Acute Lymphocytic Leukemia Treated?
Treatment of acute lymphocytic leukemia 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 be hospitalized for a few weeks. Later, you
may be able to continue treatment as an outpatient.
In the event you have a low white blood cell count, you’ll most
likely have to spend time in an isolation room to ensure protection 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 is a complete match.
How Is Acute Lymphocytic Leukemia Prevented?
There’s no confirmed cause of acute
lymphocytic leukemia. However, you should avoid the risk factors for it, which
- radiation exposure
- chemical exposure
- exposure to viral infections
- cigarette smoking
- prolonged exposure to diesel fuel,
gasoline, pesticides, and electromagnetic fields
Abdul Wadood Mohamed and Matthew Solan
Medically Reviewed by:
Jul 18, 2012
Published By: Healthline Networks, Inc.