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Overview
Acute lymphoblastic leukemia also called acute lymphocytic leukemia is a kind of blood cancer. Children under the age of 5 and adults over the age of 50 are more prone to this kind of condition. Also, it is most common among male gender as compared to females.
Upon treatment and management of this disease, complete remission is possible. Through it, all the signs and symptoms of cancer cells do disappear. It is very necessary to understand the potential causes, conditions, and treatment to understand the progression of this disease and to be aware of what to expect when one’s loved one is diagnosed with ALL.
Consulting Doctor
Cancer specialist or hematologist-Oncologist.
Symptoms
Symptoms due to low blood cell count:
-Fatigue (being tired)
-Weakness
-Loss of consciousness
-Difficulty breathing.
-Change in skin color (pale)
-Recurrent infections.
-Small red or purple spots on the skin (bruises)
-Nose bleeding, gum bleeding, and heavy menstruation.
Symptoms that appear generally:
-Loss of body weight.
-High body temperature.
-Sweating at night.
-Decreased appetite.
Thymus is enlarged in ALL diagnosis and its symptoms include the following:
-Edema and blue skin in the face, neck, arms, and upper chest region.
-Cephalgy (pain in the head)
-Alteration in consciousness.
Causes
ALL is a type of cancer that is caused by variations in genes. If a portion of a gene is damaged, broken, mutated, or deleted, it is possible to develop ALL.
Some of the genetic changes from this cancer are inherited and are found in a child from birth. However, in most cases, ALL occur in a child after birth due to genetic changes. These are the genetic changes that are then mutated and passed down the lineage. TA genetic condition that increases the risk to ALL includes the following:
Down syndrome
Fanconi anemia
Li-Fraimeni syndrome
Bloom syndrome
Kleinfelter syndrome
Neurofibromatosis.
The factors that develop these genetic changes are not completely known and these factors most likely affect young adults rather than individuals in their childhood ages.
Factors that cause genetic damage and case mutation are the following:
-Radiation exposure.
-Exposure to harmful chemicals like benzene.
-Infection by human T lymphoma HTLV-1 or Epstein Barr Virus.
Upon successful elimination of risk factors of ALL, the probability of developing this disease decreases but it is impossible to completely prevent this disease.
Most individuals with ALL do not show any risk factor and there is no way to know the full cause of ALL in an individual.
Prevention
Some lifestyle changes can be made to prevent ALL. These include the following:
- Do not smoke: There is a direct association between smoking and various types of cancer. Therefore, avoiding smoking or quitting if you are a current smoker would decrease the risk of developing ALL.
- Keep watch on weight: Obesity is related to various types of leukemia. Therefore maintaining a healthy weight can reduce the risk of ALL. This can be done by implementing a balanced diet and physical activity in day-to-day life.
- Do not breathe in chemicals: Chemicals like benzene and formaldehyde are directly related to the risk of developing ALL. These chemicals are found in some workplaces. Avoiding exposure to these chemicals would likely prevent the occurrence of ALL.
Treatment
- Induction and consolidation therapy:: In this phase, leukemia cells are killed which is followed by induction therapy in which the remaining cells are killed.
- Maintainenece therapy: This is used if a person undergoes remission after consolidation therapy. This can help to protect one from cancer for a couple of years. This treatment focuses on killing cancer cells from the central nervous system (brain and spinal cord).
- Chemotherapy: Medication kills the multiplication of cells. A combination of the drugs is also used and ALL found in the pediatric population are often treated with lower doses of chemotherapeutic drugs.
A few common drugs used in chemotherapy include the following:
-Adriamycin (doxorubicin)
-Cerubidine (daunorubicin)
-Neosar (cyclophosphamide)
-Trexall (methotrexate)
Tests Required for Diagnosis
1, Flow cytometry is used to determine the type of cancer that is developed in the cells and if the cells have become cancerous. It is also used to determine if the cancer is ALL (Acute lymphoblastic leukemia) or AML (Acute Myeloid Leukemia)
2. Cytogenetic or chromosomal test that can identify changes in genes like chromosomal translocation.
3. Test to identify a genetic mutation that can be causing cancer.
4. Lumbar puncture/spinal tap in which cerebrospinal fluid is removed from the lower portion of the spine to check if the leukemia cells have spread to the central nervous system (brain and spinal cord)
5. X-rays, ultrasound, CT scan, and MRI.
6. Blood test.
7. Bone marrow aspiration and biopsy.
8. Lumbar puncture.(spinal tap).
9. Lymph node biopsy.
Useful info
-One should start treatment for ALL as soon as this disease is diagnosed.
-ALL stands for both Acute lymphoblastic leukemia and Acute leukemoid leukemia.
-Blood cells and immune systems are affected by ALL.
-Subtypes of ALL are also present.
-The type of treatment of ALL is based on its subtype and risk factor associated with it.
-ALL is a curable disease in the pediatric population.
-Remission of ALL and the population of adults who are affected by ALL have increased significantly in the last 30 years.
-One should choose the right doctor for ALL treatments and should follow up with them till ALL is fully treated.
-Consult the oncologist about the diagnostic tests ordered and for interpretation of results.
-Records of the test result and treatment plan should be kept intact in case of recurrence for future reference.
References
- Cassaday, R. (n.d.). ACUTE LYMPHOBLASTIC LEUKEMIA. ILS. Retrieved April 26, 2023, from https://www.lls.org/leukemia/acute-lymphoblastic-leukemia
- American Cancer Society (n.d.). Signs and Symptoms of Acute Lymphocytic Leukemia (ALL). Cancer. Retrieved April 26, 2023, from https://www.cancer.org/cancer/acute-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html
- Gersten, T., & McNully, M. (2021, April 20). Acute Lymphoblastic Leukemia (ALL): An Overview. My Leukemia Team. Retrieved April 26, 2023, from https://www.myleukemiateam.com/resources/acute-lymphoblastic-leukemia-all-an-overview
