Acute lymphoblastic leukemia (ALL) is a rapidly spreading cancer that affects the white blood cells. Lymphocytes are a variety of white blood cells that are involved in fighting infections. In this disease, the bone marrow manufactures many unformed cells called blasts that would develop into lymphocytes in a healthy person. In ALL, however, these blasts fail to develop and are unable to fight infections. These abnormal cells, known as leukemia cells, multiply rapidly, crowding out the healthy blood cells that the body needs.
Acute lymphoblastic leukemia is diagnosed when blood and bone marrow tests reveal a large quantity of abnormal lymphocyte blasts. Following this diagnosis, doctors will perform tests to determine what specific type of lymphocyte cells is affected. Further tests measuring the size and quantity of leukemia cells will help the physician know how far the disease has advanced. Cytogenetics is an area of tests that may be used to reveal the alterations that have developed in the chromosomes of leukemia cells. A lumbar puncture will be used to ascertain if the cancer cells are present in the fluid surrounding the central nervous system.
The types and magnitude of symptoms patients with acute lymphoblastic leukemia develop depend on the quantity of leukemia cells present and the degree in which they have reduced the number of red blood cells, white blood cells, and platelets. A low red blood cell count can result in anemia with the accompanying fatigue and weakness. As white blood cells are infection fighters, a low quantity of these can result in fever and frequent occurrences of infections. Platelets play a role in blood clotting, so a low quantity of these cells will result in easy bleeding and bruising. High quantities of leukemia cells can also cause joint or bone pain, poor appetite, and vomiting.
As acute lymphoblastic leukemia grows rapidly, doctors normally start treatment immediately. Chemotherapy, which is medication that kills cancer cells, will be prescribed for every ALL patient. Radiation therapy normally is not prescribed in ALL with the exception of cases involving children, where the disease is likely to be in the central nervous system. A bone marrow transplant (BMT), also known as cord blood transplant, provides the best likelihood of long-term remission. As transplants can cause serious problems, this option is recommended for patients who are unlikely to get long-term remission using chemotherapy by itself.
Prognosis of acute lymphoblastic leukemia will be affected by certain factors. The age of the patient will influence recovery. Other factors involve whether the malignant cells have reached the brain and spinal cord, and whether or not the cancer has reoccurred.
