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Acute lymphocytic leukemia

Definition


Disease: Acute lymphocytic leukemia Acute lymphocytic leukemia
Category: Blood diseases & tumors
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Disease Definition:

ALL (Acute lymphocytic leukemia) is a type of cancer of the blood and bone marrow, which is the spongy tissue inside bones where blood cells are made. In acute lymphocytic leukemia, the "acute" refers to the fact that the disease affects immature blood cells and progresses rapidly. Lymphocytic refers to the white blood cells, which are called lymphocytes that this condition affects.

Treatments for acute lymphocytic leukemia result in a good chance for a cure. It is also the most common type of cancer in children. Although ALL can occur in adults too, its prognosis is not as optimistic.

This disease is also known as acute childhood leukemia and acute lymphoblastic leukemia.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Acute lymphocytic leukemia may cause these signs and symptoms:

  • Fever
  • Weight loss
  • Pale skin
  • Frequent infections
  • Weakness, fatigue, exhaustion or a general decrease in energy.
  • Loss of appetite
  • Bleeding from the gums
  • Shortness of breath
  • Severe or frequent nosebleeds
  • Lumps caused by swollen lymph nodes in and around the neck, underarm, stomach or groin.

Although many signs and symptoms of ALL resemble those of the flu, but they don't improve, as those of the flu do. If signs and symptoms don't improve as expected, or if they become persistent and concerning, a doctor should be consulted.

Causes:

When a bone marrow cell develops errors in its DNA that tell the cell to continue to grow and divide when a healthy cell would normally die, blood cell production goes uneven and ALL occurs. The bone marrow produces immature cells that develop into leukemic white blood cells called lymphoblasts, which are abnormal cells that are unable to function properly, so they build up and crowd out healthy cells.

Although it has been discovered that ALL isn't inherited, the cause of DNA mutations that lead to ALL hasn't yet become clear.

Complications

Complications:

None

Treatments:

Usually, acute lymphocytic leukemia treatment falls into separate phases:

THE 1ST PHASE: INDUCTION THERAPY
In this phase most of the leukemia cells in the blood and bone marrow are killed.

THE 2ND PHASE: CONSOLIDATION THERAPY
In this phase, the remaining leukemia cells in the brain or spinal cord are killed. This phase is also called post-remission therapy.

THE 3RD PHASE: MAINENANCE THERAPY
In this phase the leukemia cells are prevented from growing. Usually, the medications used in this stage are given at much lower doses.

THE 4TH PHASE: PREVENTIVE TREATMENT TO THE SPINAL CORD
In this phase chemotherapy drugs are injected directly into the fluid that covers the spinal cord, and the cancer cells that can't be reached by chemotherapy drugs given by mouth or through an intravenous line are killed.

During each phase of therapy, patients may also receive treatment to kill leukemia cells hiding in the central nervous system.
Each of these phases usually take from two and a half to three and a half years.

Some of the treatment options may be:

Chemotherapy:
This is the most common form of induction therapy for children and adults with ALL. Chemotherapy uses drugs to kill cancer cells, and because the drugs destroy many normal blood cells in the process of killing leukemia cells, this method may cause anemia, infection and bleeding. Because of this, an extended hospital stay is required. During the consolidation and maintenance phases, these drugs could also be used, but these phases are usually less intensive regimens and don't require staying in the hospital.

Targeted drug therapy:
These drugs target and attack specific abnormalities present in cancer cells that help them grow and thrive. One of these targeted drugs is imatinib , which particularly attacks cancer cells that have a certain abnormality called the Philadelphia chromosome. The drug dasatinib  also works in a similar way. These drugs are only approved for people with the Philadelphia chromosome-positive form of ALL. There's yet another drug called riutxumab , which targets cancer cells that have an overabundance of a certain protein. This treatment may be combined with chemotherapy drugs.

Radiation therapy:
Radiation may be recommended if the cancer cells have spread to the central nervous system. This therapy uses high-powered beams to kill cancer cells, such as X-rays.

Bone marrow stem cell transplant:
In people at high risk of relapse or for treating relapse when it occurs, a bone marrow stem cell transplant may be used as consolidation therapy. It allows a leukemia patient to re-establish healthy stem cells by replacing leukemic bone marrow with leukemia-free marrow. This treatment begins with high doses of chemotherapy or radiation in order to destroy any leukemia-producing bone marrow, which is then replaced by bone marrow from a compatible donor (allogeneic transplant). Sometimes, people are able to use their own bone marrow for transplantation, which may be possible if the patient goes into remission and a healthy bone marrow is then harvested for a future transplant.
 

Prognosis:

Not available

Expert's opinion

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