Acute lymphoblastic leukemia

Blood cancer characterised by overproduction of lymphoblasts

Acute lymphoblastic leukemia
Synonyms	Acute lymphocytic leukemia, acute lymphoid leukemia
Pronounce	N/A
Field	Hematology, oncology
Symptoms	Feeling tired, pale color, fever, easy bleeding or bruising, bone pain, enlarged lymph nodes<ref name=NCI2017Pt/>
Complications	Infection, tumor lysis syndrome
Onset	2–5 years old
Duration
Types	B-cell ALL, T-cell ALL
Causes	Usually unknown<ref name=MDAnd2016/>
Risks	Identical twin with ALL, Down syndrome, Fanconi anemia, ataxia telangiectasia, Klinefelter syndrome, high birth weight, significant radiation exposure
Diagnosis	Blood tests and bone marrow examination
Differential diagnosis	Infectious mononucleosis, acute myeloid leukemia, lymphoblastic lymphoma, aplastic anemia
Prevention
Treatment	Chemotherapy, stem cell transplantation, radiation therapy, targeted therapy
Medication
Prognosis	Children: 90% five-year survival rate> Adults: 35% five-year survival
Frequency	1 in 1,750 children
Deaths	111,000 (2015)

In ALL, lymphoid cell development stops at the lymphoblast (arrow), which are also overproduced

Acute Lymphoblastic Leukemia (ALL) is a type of cancer that primarily affects the white blood cells known as lymphocytes. It is characterized by the rapid development of immature lymphocytes, which crowd out other healthy cells in the bone marrow.

Overview and Etiology

ALL is most prevalent in children, with a peak incidence between the ages of two and five years. However, it can also occur in adults, where it generally carries a poorer prognosis. The exact cause of ALL is unknown, although it is thought to be a combination of genetic and environmental factors.<ref>Belver, L.,

 The genetics and treatment of acute lymphoblastic leukaemia, 
 Nature Reviews Cancer, 
 2020,
 Vol. 20,
 pp. 227–246,
 DOI: 10.1038/s41568-019-0232-4,</ref>

Signs and Symptoms

Symptoms of ALL can vary but often include fatigue, fever, bleeding or bruising easily, frequent infections, bone or joint pain, and swollen lymph nodes.

Diagnosis

Diagnosis is typically made via blood tests and bone marrow examination. The presence of immature lymphocytes, or lymphoblasts, in the blood or bone marrow is characteristic of ALL. Molecular and genetic tests may also be used to further characterize the disease and guide treatment decisions.<ref>Campana, D.,

 Minimal residual disease in acute lymphoblastic leukemia, 
 Hematology, 
 2010,
 Vol. 2010,
 pp. 7–12,
 DOI: 10.1182/asheducation-2010.1.7,</ref>

Treatment

Treatment for ALL generally involves chemotherapy, which can be divided into several phases including induction, consolidation, and maintenance. Other treatments, such as radiation therapy or stem cell transplantation, may be utilized in certain cases. The specific treatment plan depends on various factors such as patient age, disease subtype, and genetic profile.<ref>Pui, C.H.,

 Acute lymphoblastic leukemia: Diagnosis and treatment, 
 Mayo Clinic Proceedings, 
 2016,
 Vol. 91,
 pp. 1645–1666,
 DOI: 10.1016/j.mayocp.2016.09.010,</ref>

Prognosis

The prognosis for ALL varies and depends on a multitude of factors. However, the survival rate in children is generally favorable, with about 90% achieving a long-term cure. In adults, the prognosis is less favorable but has improved significantly with advancements in treatment.

• 
  acute lymphoblastic leukemia (ALL), peripheral blood of a child, Pappenheim stain, magnification x100
• 
  bone marrow smear (large magnification) from a person with acute lymphoblastic leukemia
• 
  bone marrow smear from a person with acute lymphoblastic leukemia

References

<references />

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