Acute Lymphocytic Leukemia (ALL)

Overview

Acute lymphocytic leukemia – or ALL – is a type of cancer that affects the blood and bone marrow. Bone marrow is the spongy tissue located inside the bones. ALL progresses quickly and causes the creation of immature lymphocytes, a type of white blood cell. This condition is also known as acute lymphoblastic leukemia. ALL is the most common type of cancer diagnosed in children, though it can also occur in adults.

Acute lymphocytic leukemia causes

ALL is caused when bone marrow cells develop a mutation (change) in their DNA.

Acute lymphocytic leukemia risk factors

The following factors may increase your risk for developing ALL:

• Being exposed to high levels of radiation, such as during a nuclear reactor accident
• Having certain genetic disorders, such as Down syndrome
• Having undergone radiation therapy

Acute lymphocytic leukemia symptoms

Signs and symptoms of ALL can include:

• Bloody gums
• Decreased energy
• Fatigue
• Fever
• Frequent infections
• Frequent, severe nosebleeds
• Pain in the bones
• Pale skin
• Shortness of breath
• Swollen lymph nodes that can be felt
• Weakness

Acute lymphocytic leukemia diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors. 
• Blood tests – your doctor will send a sample of your blood to the laboratory for close analysis. The lab can determine if the blood has unusual levels of white blood cells, which may indicate ALL.
• Bone marrow biopsy – in this test, your doctor removes a biopsy (small tissue sample) from the bone marrow. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancerous cells. 
• Computerized tomography (CT) scan – this type of imaging test provides a 3-D image of the inside of the body that your doctor can use to determine the size and location of the suspected cancer. Your doctor can also use the CT scan to help determine if the cancer has spread beyond the initial site.
• Spinal tap – during this test, your doctor removes a sample of spinal fluid (the fluid that surrounds your spinal cord and brain). This sample is sent to the laboratory, where a specialist closely checks the spinal fluid for cancerous cells.

Acute lymphocytic leukemia treatment

Depending on your personal health history, the extent of the ALL and other factors, your oncologist may recommend one or more of the following treatment options:

• Bone marrow transplant – also known as a stem cell transplant, this treatment involves infusing your diseased bone marrow with healthy bone marrow. Doing so can help your body fight the cancer.
• Chemotherapy – during this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. Your doctor may recommend this treatment option if the cancerous cells have spread to your central nervous system.
• Stem cell transplant – this treatment involves infusing healthy stem cells into your blood to help your body destroy cancerous cells and resume healthy white blood cell production.
• Targeted therapy – in this treatment, specialized medications kill cancerous blood cells. Targeted therapy may help preserve more surrounding healthy tissue than other treatment options.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.