What is acute lymphocytic leukemia (ALL)?

ALL is cancer that affects the blood and bone marrow. The bone marrow makes white blood cells (WBC), red blood cells (RBC), and platelets. WBCs help fight infection. RBCs help carry oxygen throughout the body. Platelets help the blood clot. ALL causes your body to make too many immature (young) white blood cells (WBC). These cells are cancer (leukemia) cells, and cannot fight infection like healthy WBCs. Cancer cells crowd the bone marrow and prevent it from making healthy blood cells. Without enough healthy blood cells, you are at risk for infection, bleeding, and anemia. Anemia is a low level of red blood cells.

What causes ALL?

The exact cause of ALL is not known. The following may increase your risk for ALL:

• A history of treatment with chemotherapy or radiation therapy
• Age older than 70 years
• Exposure to high levels of radiation in the environment
• Genetic disorders, such as Down syndrome

What are the signs and symptoms of ALL?

• Fever or night sweats
• Easy bleeding or bruising
• Bone or rib pain
• Frequent illnesses, such as colds, coughs, or the flu
• Swollen lymph nodes in your neck, armpits, or groin
• Shortness of breath or feeling very tired
• Weight loss without trying or loss of appetite

How is ALL diagnosed?

• Blood tests may be done to check your blood cell levels.
• X-rays check for swollen lymph nodes in your chest.
• A bone marrow biopsy is a procedure to take a sample of bone marrow from your hip bone. This test helps healthcare providers find out which type of leukemia you have.
• A lumbar puncture is a procedure to remove fluid from around your spinal cord. The fluid is tested for cancer cells.
• Other tests , such as an MRI or PET scan, may be done if ALL is diagnosed with any of the above tests. These tests will check if the cancer has spread to other parts of your body.

How is ALL treated?

Treatment may depend on the results of testing. You will get treatment in 2 phases. In the first phase, healthcare providers will give you treatments to make your ALL go into remission. This phase can sometimes take several years. Remission means there are no longer any signs of leukemia. After you are in remission, you will get postremission treatment. The goal of this phase is to kill any hidden leukemia cells and help you stay in remission. The following treatments may be given in either stage:

• Supportive care includes medicines and blood transfusions. Medicines may be given to prevent infections. Blood transfusions may be given to increase your level of red blood cells, white blood cells, or platelets.
• Chemotherapy is used to kill cancer cells. Your healthcare provider may give you 2 or more kinds of chemotherapy.
• Targeted therapy is medicine that finds and kills cancer cells.
• Radiation therapy shrinks tumors and kills cancer cells with x-rays or gamma rays. It may be given alone or with chemotherapy to treat cancer.
• A stem cell transplant is a procedure to replace cancer cells with healthy blood cells. Stem cells are taken from a donor and injected into your blood. The stem cells go to your bone marrow and become new, healthy blood cells.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

• prednisone
• Trexall
• methotrexate
• Cerubidine
• vincristine

View more treatment options

What can I do to manage my ALL?

• Prevent infection. Wash your hands often, avoid people who are sick, and clean humidifiers daily. Ask your healthcare provider for more information on how to prevent infection.
• Prevent bleeding and bruising. Use an electric razor to shave. Do not play contact sports, such as football. Use a soft toothbrush. Do not floss your teeth when your platelet count is low. Blow your nose gently. Do not take NSAIDs or aspirin. NSAIDs and aspirin prevent platelets from helping your blood clot. This increases your risk for bleeding. Be careful with sharp tools or objects.
• Do not smoke cigarettes or drink alcohol. Alcohol can thin your blood and make it easier to bleed. Smoking increases your risk for new or returning cancer. Smoking can also delay healing after treatment. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke or drink and need help quitting.
• Drink liquids as directed. You may need to drink extra liquids to prevent dehydration. You may be at risk for dehydration if you vomit or have diarrhea from cancer treatments. Ask how much liquid you need each day and which liquids are best for you.
• Exercise as directed. Exercise can help you have more energy. Ask your healthcare provider to help you create an exercise plan.
• Eat healthy foods. Healthy foods may help you feel better and have more energy. Examples of healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask about any extra nutrition you may need, such as nutrition shakes or vitamins.

Further information

• The Leukemia & Lymphoma Society Inc.
  1311 Mamaroneck Avenue
  White Plains , NY 10605
  Phone: 1- 914 - 949-5213
  Phone: 1- 800 - 955-4572
  Web Address: http://www.leukemia-lymphoma.org
  

• American Cancer Society
  250 Williams Street
  Atlanta , GA 30303
  Phone: 1- 800 - 227-2345
  Web Address: http://www.cancer.org
  

Call 911 or have someone else call for any of the following:

• You feel short of breath or have chest pain.
• You cannot be woken.
• You faint or lose consciousness.

When should I seek immediate care?

• Your temperature is greater than 100.4°F (38°C).
• You have heavy bleeding.
• Your heart is beating faster than usual.
• You have blood in your urine or bowel movements.

When should I contact my healthcare provider?

• You have nausea or are vomiting.
• You have bruising not caused by an injury.
• You have questions or concerns about your condition or care.

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