What is acute lymphocytic leukemia (ALL)?
Acute lymphocytic leukemia (ALL) is acancerof the blood and bone marrow. In ALL, there’s an increase in a type ofwhite blood cell (WBC)known as alymphocyte. Because it’s anacute, or aggressive, form of cancer, it moves rapidly.
ALL is the most common childhood cancer. Children younger than age 5 have the highest risk. It can also occur in adults.
There are two main subtypes of ALL,B-cell ALL and T-cell ALL. Most types of ALL can be treated with a good chance of remission inchildren. Adults with ALL don’t have as high of a remission rate, but it’s steadily improving.
The National Cancer Institute (NCI) estimates
Having ALL increases your chances of bleeding and developing infections. The symptoms and signs of ALL may also include:
- paleness(pallor)
- bleeding from the gums
- a fever
- bruisesorpurpura(bleeding within the skin)
- petechiae(red or purple spots on the body)
- lymphadenopathy(characterized byenlarged lymph nodesin theneck,under the arms, or in thegroin region)
- enlarged liver
- enlarged spleen
- bone pain
- 联合pain
- weakness
- fatigue
- shortness of breath
- testicular enlargement
- cranial nervepalsies
Although doctors don’t yet know the specific causes of ALL, they have identified a few risk factors of the condition.
Radiation exposure
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 a
Studies done in the 1950s showed that fetuses exposed to radiation, such as inX-rays, within the first months of development present an increased risk for ALL. However,more recent studieshave failed to replicate these outcomes.
Chemical exposures
Prolonged exposure to certain chemicals, such as
Some chemotherapy drugs may cause second cancers. If a person has a second cancer, it means they were diagnosed with cancer and, afterward, developed a different and unrelated cancer.
Some chemo drugs may put you at risk for developing ALL as a second cancer. However,acute myeloid leukemia (AML)更有可能发展交会ond cancer than ALL.
If you do develop a second cancer, you and your doctor will work toward a new treatment plan.
Viral infections
A2010 studyreports that various viral infections have been linked to an increased risk for ALL.
T cellsare a particular type of WBC. Contracting human T-cell leukemia virus-1 (HTLV-1) can cause a rare type of T-cell ALL.
Epstein-Barr virus (EBV), which is usually responsible forinfectious mononucleosis, has been linked to ALL andBurkitt’s lymphoma.
Inherited syndromes
ALL doesn’t appear to be an inherited disease. However, some inherited syndromes exist with genetic changes that raise the risk of ALL. They include:
- Down syndrome
- Klinefelter syndrome
- Fanconi anemia
- Bloom syndrome
- ataxia-telangiectasia
- neurofibromatosis
People who havesiblingswith ALL are also at aslightly increasedrisk for the disease.
Race and sex
Some populations have ahigher riskfor ALL, although these differences in risk aren’t yet well-understood. Hispanics and Caucasians have shown a higher risk for ALL than African-Americans. Males have a higher risk than females.
Other risk factors
Experts have also studied the following as possible links to developing ALL:
- cigarette smoking
- long exposure to diesel fuel
- gasoline
- pesticides
- electromagnetic fields
Your doctor must complete a full physical exam and conduct blood and bone marrow tests to diagnose ALL. They’ll likely ask about bone pain, since it’s one of the first symptoms of ALL.
Here are some of the possible diagnostic tests you might need:
Blood tests
Your doctor may order ablood count. People who have ALL may have a blood count that showslow hemoglobinanda low platelet count. TheirWBC countmay or may not be increased.
Ablood smearmay show immature cells circulating in the blood, which are normally found in bone marrow.
Bone marrow aspiration
Bone marrow aspirationinvolves taking a sample of bone marrow from your pelvis or breastbone. It provides a way to test for increased growth in marrow tissue and reduced production of红细胞.
It also allows your doctor to test for dysplasia. Dysplasia is an abnormal development of immature cells in the presence ofleukocytosis(increased WBC count).
Imaging tests
Achest X-raycan allow your doctor to see if the mediastinum, or the middle partition of your chest, is widened.
ACT scanhelps your doctor determine whether cancer has spread to your brain, spinal cord, or other parts of your body.
Other tests
Aspinal tapis used to check if cancer cells have spread to your spinal fluid. Anelectrocardiogram (EKG)andechocardiogramof your heart may be performed to checkleft ventricular function.
Tests onserum ureaand renal andliver functionmay also be done.
Treatment of ALL 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.
Chemotherapyis used to treat this type of leukemia. For the first treatment, you may have to stay in the hospital for a few weeks. Later, you may be able to continue treatment as an outpatient.
In the event you have a low WBC count, you’ll most likely have to spend time in an isolation room. This ensures you’re protected from contagious diseases and other problems.
Abone marroworstem celltransplant may be recommended if your leukemia doesn’t respond to chemotherapy. The transplanted marrow may be taken from a sibling who’s a complete match.
Of the nearly 6,000 Americans who receive a diagnosis of ALL in 2018, the
The
Although most cases of ALL appear in children and teens, around
Per the NCI, the five-yearsurvival ratefor Americans of all ages is
A variety of factors determines a person’s outlook. They include age, ALL subtype, WBC count, and whether or not ALL has spread to nearby organs or cerebrospinal fluid.
Survival rates for adults aren’t as high as survival rates for children, but they’re steadily improving.
According to the American Cancer Society,
Children with ALL stand a very good chance of being cured.
There’s no confirmed cause of ALL. However, you can avoid several risk factors for it, such as:
- radiation exposure
- chemical exposure
- exposure to viral infections
- cigarette smoking
prolonged exposure to diesel fuel, gasoline, pesticides, and electromagnetic fields