Acute lymphocytic leukemia

Cancer starts when the cells in any part of the body divide out of control. They can also spread to other parts of the body through the process called metastasis.

Acute lymphocytic leukemia (ALL) or acute lymphoblastic leukemia is cancer which occurs due to the endless division of the white blood cells in the bone marrow (spongy tissue in the bone). This results in the production of immature blood cells. It is termed as acute because it progresses very rapidly and becomes fatal within a few months if not treated. However, the cancers which start in other body parts but spread to the bone marrow are not considered as acute lymphocytic leukemia.

ALL is more common in children and is easy to cure compared to that which occurs in adults.

Symptoms

Your chances of bleeding and infections increase if you have ALL. You may have

  • Bleeding from the gums and nose
  • Bruising, bleeding or purpura within the skin
  • Petechiae (red or purple colored spots on the body)
  • Lymphadenopathy (enlarged painless lymph nodes in the neck, abdomen, underarms and groins)
  • Bone pain

The other associated symptoms include shortness of breath, fatigue, weakness, and tiredness.

Causes

Acute lymphocytic leukemia occurs due to the mutations in the DNA of the bone marrow cells. Consequently, the cells grow and divide continuously. However, the cause of mutations in the DNA is still unclear.

Coping and support

As the treatment for ALL is long way, often 2 to 3 years, you may help yourself to cope up with this by:

  • Learning about your condition and making informed choices about the treatment
  • Relying on your health care team members
  • Exploring programs for children with ALL
  • Making family and friends understand your condition.

Risk factors

SYour risk for getting acute lymphocytic leukemia is high if you have undergone cancer therapy in your past, or were exposed to radiations or chemicals such as benzene, hair dyes, etc. Also, certain genetic disorders such as Down syndrome, Klinefelter’s syndrome can increase your risk for ALL. If your siblings have ALL, you may also be at risk of developing the condition.

Complications

If your condition is left untreated, you may develop the below complications:

  • a weak immune system which makes you more prone to infections
  • bleeding in the skull, lungs, and stomach

When to seek medical advice?

If your signs and symptoms are persistent and bothering, then you must consult doctor. Before getting doctor’s help, it is better to avoid activities which can worsen your signs and symptoms.

It is a good idea to be well-prepared before going for an appointment.

  • Know what type of diet you need to follow
  • Remember all the symptoms you are experiencing
  • Prepare a list of all the medications you are taking
  • Note down the relevant personal information
  • Have someone to accompany you to the hospital
  • Note down the questions you need to ask your doctor

Your doctor may order for any of the below tests to diagnose and confirm whether you have ALL or not. If you have ALL, you may have the following results with the below tests.

Blood tests: It shows numerous white blood cells but fewer red blood cells and platelets. Also, certain immature cells called the blast cells may be present.
Bone marrow test : A sample of bone marrow is removed from the hip bone and tested. Based on the changes in the color, shape, size and such other features, your doctor determines the origin of cancer and plans for the treatment accordingly.
Blood tests: It shows numerous white blood cells but fewer red blood cells and platelets. Also, certain immature cells called the blast cells may be present.
Imaging tests: Tests such as X-rays and CT-scan or ultrasound scan detects whether cancer has spread to the other body parts.
Spinal fluid test: The sample is collected from the spinal fluid (surrounding the brain and spinal cord) to check for the spread of cancer.

Acute lymphocytic leukemia treatment involves 4 phases, and the duration of each phase varies with your situation:

The following types of surgeries are considered:

Induction phase : In this first phase of treatment, most of the cancer cells in the blood and bone marrow are destroyed, and the normal blood cell cycle is attained.

Consolidation phase : In this phase, the residual or remaining cancer cells which have spread to the parts such as brain and spinal cord, are killed.

Maintenance therapy : A lower dose of therapy given for nearly months to years during this phase prevents the cancer cells from growing back.

Preventive treatment : To prevent the spread of cancer cells to the spinal fluid, the drugs are directly injected into the spinal fluid.

Below are the treatment options:

Chemotherapeutic agents: These drugs kill the cancer cells and are used in the first 3 phases.

Targeted drug therapy: These drugs specifically act on the abnormalities in the cancer cells and prevent them from dividing abnormally. For example, imatinib, nilotinib, etc.

Radiation therapy: High-energy radiations such as X-rays are used to kill the cancer cells which have spread to the CNS (i.e. brain and spinal cord).

Stem cell transplant: If the risk of relapse is high, then this therapy is indicated. In this approach, the cancer cells in the bone marrow are replaced with normal cells from a healthy individual.

Although there are no alternative therapies to treat ALL, some therapies as mentioned below can improve the symptoms of leukemia.

  • Meditation
  • Acupuncture
  • Massage
  • Aromatherapy
  • Relaxation exercises
It is quite important to discuss with your doctor before going for any alternative therapies, as they can interfere with the other chemotherapeutic approaches.