Acute Lymphocytic Leukemia

What is leukemia?

Leukemia is cancer of the blood cells, usually the white blood cells.

What are the types of leukemia?
There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine if the cancer is:

1. lymphocytic or myelogenous leukemia:
Cancer can occur in either the lymphoid or myeloid white blood cells.

When the cancer develops in the lymphocytes (lymphoid cells), it is called lymphocytic leukemia.

When the cancer develops in the granulocytes or monocytes (myeloid cells), it is called myelogenous leukemia.

2. acute or chronic leukemia:
Leukemia is either acute or chronic.

acute leukemia
The new or immature cells, called blasts, remain very immature and cannot perform their functions. The blasts increase in number rapidly, and the disease progresses quickly.

chronic leukemia
There are some blast cells present, but they are more mature and are able to perform some of their functions. The cells grow more slowly, and the number increases less quickly, so the disease progresses gradually.

Based on these findings, the leukemia is then classified into one of the four main types of leukemias: acute myelogenous leukemia (AML); chronic myelogenous leukemia (CML); acute lymphocytic leukemia (ALL); or chronic lymphocytic leukemia (CLL).

What is acute lymphocytic leukemia?

Acute lymphocytic leukemia (ALL) is a cancer of the blood in which too many lymphocytes, a type of white blood cell, are produced by the bone marrow and by organs of the lymph system.

Normally, the lymphocytes fight infection by making antibodies that attack harmful elements. But, in ALL, the cells are immature and overabundant. They crowd out other blood cells, and may collect in the blood, bone marrow, and lymph tissue.

Acute leukemia can occur over a short period of days to weeks. Chromosome abnormalities (extra chromosomes and structural changes in the chromosome material) are present in the majority of all patients.

ALL is more common in children than adults, with most children being under the age of 10 when the cancer is found. According to the American Cancer Society, of the 35,070 leukemia cases expected in 2006, ALL will account for 3,930 of the acute cases. The chance of someone 30 years old developing ALL is one in 200,000

What are the symptoms of acute lymphocytic leukemia?

The following are the most common symptoms of acute lymphocytic leukemia. However, each individual may experience symptoms differently. Symptoms may include:

anemia
bleeding
bruising
fever
persistent weakness
fatigue
aches in bones and joints
swollen lymph nodes

The symptoms of acute lymphocytic leukemia may resemble other blood disorders or medical problems. Always consult your physician for a diagnosis.

How is acute lymphocytic leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for acute lymphocytic leukemia may include the following:

additional blood tests and other evaluation procedures
bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
spinal tap/lumbar puncture - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.

Treatment for acute lymphocytic leukemia:

Specific treatment for acute lymphocytic leukemia will be determined by your physician based on:

your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Treatment may include:

chemotherapy
radiation therapy
bone marrow transplantation
targeted therapy
monoclonal antibodies