Leukemia (Acute Lymphocytic)

Acute Lymphocytic Leukemia

What is acute lymphoblastic leukemia? — Acute lymphoblastic leukemia, called "ALL," is a type of blood cancer. ALL is fast-growing and needs to be treated quickly.
Blood is made up of different types of cells. These cells are made in the center of your bones, in a part called the bone marrow.
When people have ALL, their bone marrow makes abnormal blood cells instead of normal blood cells. These abnormal blood cells grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body.
When the bone marrow makes abnormal blood cells, it does not make the normal blood cells a person's body needs. This can cause symptoms.
What are the symptoms of ALL? — The most common symptoms of ALL include:
Feeling very tired and weak
Bleeding or bruising more easily than normal
Getting sick from infections more easily than normal
Is there a test for ALL? — Yes. Your doctor or nurse will talk with you and do an exam. He or she will also do:
Blood tests
Bone marrow biopsy – A small sample of the bone marrow will be examined under a microscope to see if ALL cells are present.
How is ALL treated? — Treatment for ALL is usually made up of 3 parts.
The first part of treatment is called "induction of remission" and lasts about 4 weeks. During this part, people generally stay in the hospital and get chemotherapy. Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Depending on the specific type of ALL you have, you might also get other treatments. For example, "immune therapy" works with your body's infection-fighting system to kill cancer cells. "Targeted therapy" involves medicines that work only for cancers with certain characteristics.
Most people are in "remission" after getting chemotherapy. This means that doctors do not see any more abnormal ALL cells in the blood or bone marrow. But even though doctors do not see any abnormal cells, there are still ALL cells in the body. To kill these cells and prevent the ALL from returning, people need more treatment.
The second part of treatment is called "consolidation/intensification therapy" and lasts a few months. During this time, people generally have more chemotherapy. But it is given at a lower dose than the earlier chemotherapy, and you might not need to stay in the hospital overnight.
The third part of treatment is called "maintenance therapy" and might last 2 or 2 ½ years. During maintenance therapy, people get chemotherapy once a month. They also take other medicines (pills) on certain days of the month. Many people are able to return to their usual activities during this part of treatment.
What happens after treatment? — After treatment, your doctor will check you every so often to see if the cancer comes back. Regular follow-ups include talking with your doctor, exams, and blood tests. Sometimes, you might also need a bone marrow biopsy.
What happens if the ALL comes back? — If the ALL comes back, you might have more chemotherapy, and you might also get immune therapy, radiation therapy, or a bone marrow transplant (also called "stem cell transplant"). Bone marrow transplant replaces cells in the bone marrow that are killed by chemotherapy or radiation with "donor" cells. These donor cells can come from:
•People who are related to you, and whose blood matches yours
•People who are not related to you, but whose blood matches yours
•Blood (that matches yours) from a newborn baby's umbilical cord
What else should I do? — It's important to follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for ALL involves making many choices, such as what treatment to have and when.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the risks to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15789 Version 11.0
Release: 28.2.2 - C28.105
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