Conditions & Diseases: Cancer: Leukemia Learning Center

Leukemia

Acute Lymphocytic Leukemia

Acute lymphocytic leukemia, also called acute lymphoblastic or acute lymphoid leukemia, is a progressive bone marrow and blood cancer caused by a high concentration of lymphocytes (a type of white blood cell that fights infection). ALL causes damage or death by crowding out healthy cells within the bone marrow, and by spreading to other organs.

According to the National Cancer Institute, an estimated 5330 people were diagnosed with ALL in 2010 and an estimated 1,420 died from ALL.

ALL can occur during childhood under the age of 20 with a median diagnosis age of 13, and during adulthood 20 and older. Children account for Sixty-one percent of all ALL diagnoses made each year. Despite the fact that it is the most common form of childhood leukemia, the prognosis is good with an 85 percent survival rate after 5 years. However, this type of leukemia progresses quickly if not detected and treated early.

Normally, the bone marrow produces three types of blood cells called mature blood cells.

1. Red blood cells, which carry the oxygen to all the body tissues.

2. White blood cells, which fight against infections.

3. Platelets, which control the bleeding by forming blood clots.

Subtypes of ALL

Although there are three types of lymphocytes, killer cells (which are classified as large), and B-Cells and T-Cells (which are both classified as small), acute lymphocytic leukemia only occurs with B-cells and T-Cells. Therefore, the two main subtypes are B-cell acute lymphocytic leukemia, and T-cell acute lymphocytic leukemia.

These two subtypes can be further classified, but the two systems which do so (FAB and WHO), are rather complicated. The National Marrow Donor program has a more simplied subtyping system which is:

• Family history: If there is a sibling with leukemia.
• Race: ALL is more common among Caucasians and Hispanics.
• Age: ALL is more common after the age of 70.
• Being exposed to x-rays before birth.
• Exposure to radiation.
• Chemotherapy or medical treatment with drugs that weaken the immune system.
• Genetic medical disorders (ex: Down syndrome)

Child ALL Symptoms: The symptoms can vary from patient to patient, depending on the number of leukemia cells and the area of the body where leukemia cells collect. The most common symptoms of acute lymphcytic leukemia in children include:

• Anemia, caused by a low concentration of healthy red blood cells and platelets.
• Fever
• Fatigue
• Frequent and recurrent infections
• Tender or swollen lymph nodes (in the neck, armpit, stomach or groin area)
• Easy bleeding and bruising
• Discomfort below the ribs (pain or fullness sensations)
• Small red spots beneath the skin
• Bone or joint pains
• Headaches with or without vomiting (when the lymphoblast cells collect in the brain or spinal cord) - this symptom is not common
• Testicle swelling (when the lymphoblast cells collect in the testicles) - this is also not a common symptom of ALL.

Once ALL leukemia is diagnosed, medical tests are conducted to establish subtypes and the leukemia stages (the extent or spread of leukemia). However, childhood acute lymphocytic leukemia is not classified through any standard staging system to establish how far the leukemia spread, but in risk groups. These risk groups include:

Childhood Acute Lymphocytic Leukemia Risk Groups (similar to stages)

1. Standard (low) risk: Includes children between one and nine years old with a white blood cells count less than 50,000/m L at diagnosis.

2. High risk: Includes children younger than one year or older than nine with a white blood cells count of 50,000/m L or more at diagnosis.

3. Recurrent: Refers to the leukemia that has recurred (relapsed, came back) after it was treated.

Acute Lymphocytic Leukemia in Adults

Adult Acute Lymphocytic Leukemia risk factors include:

• Gender: ALL is more common among males.
• Race: ALL is more common among white people.
• Exposure to high doses of radiation
• Past medical treatments such as chemotherapy or radiotherapy
• Genetic medical disorders, (ex: Down syndrome)

Adult ALL Symptoms: In adults, the early leukemia symptoms can be confused with flu or cold symptoms. Some of the most common symptoms include:

• Feeling tired
• Weakness
• Small red spots beneath the skin
• Easy bleeding and bruising
• Breathing difficulties (short breathing)
• Unexplained weight loss
• Loss of appetite
• Bone or stomach pain
• Discomfort below the ribs (pain or fullness sensations)
• Tender or swollen lymph nodes (in the neck, armpit, stomach or groin area)

Like childhood acute lymphocytic leukemia, adult acute lymphocytic leukemia is not classified through any standard staging system. However, there are three phases:

Adult Acute Lymphocytic Leukemia Phases (similar to stages)

1. Untreated adult ALL: In this phase, leukemia has been diagnosed and the treatment focuses only on symptoms (fever, bleeding, and pain) relief. The main characteristics of this phase are: 1) more then 5 percent of the cells in the bone marrow are leukemia cells, and 2) signs and symptoms of leukemia are present.

2. Adult ALL in remission: In this phase, leukemia has been treated. The main characteristics of this phase are: 1) less than 5 percent of the cells in the bone marrow are leukemia cells, and 2) there are no more signs and symptoms of leukemia present in the brain and spinal cord, or other organs of the body.

3. Recurrent adult ALL: In this phase, leukemia has been recurred (relapsed, came back) after it was treated.

Learn more about Treatment Options for ALL

Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com

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