Acute Lymphoblastic Leukemia

What Is Acute Lymphoblastic Leukemia?

There are two types of leukemia, acute and chronic. In acute leukemia the disease progresses rapidly, there is an accumulation of immature, useless cells in the marrow and blood. In chronic leukemia, the disease develops more slowly and allows more mature, useful cells to be made. Acute leukemia crowds out the good cells more rapidly than chronic leukemia. "Acute" means "sudden onset", while "chronic" means "long-term".

Acute lymphoblastic leukemia, also known as acute lymphocytic leukemia is when the blood and bone marrow have large numbers of white blood cells destined to become lymphocytes.

Acute lymphoblastic leukemia is commonly referred to by the acronym ALL, pronounced as three separate letters - eigh, el, el. ALL is the most common childhood cancer, especially among toddlers aged 2 to 3 years.

In the USA, ALL incidence is significantly higher among Caucasian than African-American children. Incidence is highest among Hispanic children.

In the USA there are about 6,000 new cases of ALL annually, an incidence of 1 in every 50,000 people.
In England and Wales there are approximately 2,400 diagnosed cases of acute leukemia each year, of which about 600 are ALLs. The NHS (National Health Service), UK, informs that 85% of all ALL cases occur among children aged less than 15 years.

Experts say the main causes of ALL are exposure to high levels of radiation or benzene. Smokers are three times as likely to develop ALL compared to non-smokers - benzene is one of the 4,000 substances found in cigarette smoke. Individuals who have spent over 5,000 hours in airplanes have a higher risk of developing ALL (flying exposes you to more of the Sun's radiation). About 1 in every 20 cases are thought to be caused by related genetic disorders, such as Down's syndrome.

Some scientists wonder whether early exposure to germs might protect children from developing ALL. A significantly lower percentage of children who went to playgroups at an early age develop ALL compared to those who didn't. Symptoms of acute lymphoblastic leukemia will usually start slowly, and then escalate in severity as the number of blast cells in the blood rises. Signs and symptoms may include:

• Fatigue
• Frequent unexplained bleeding, such as nosebleeds or bleeding gums
• High fever
• Oversweating
• Painful joints and/or bones
• Panting
• Several infections over a short period
• Swollen glands (lymph nodes)
• Swollen liver
• Swollen spleen
• The skin bruises easily
• The skin is paler than it should be
• Unexplained weight loss

If the affected cells spread into the CNS (central nervous system), the patient may have neurological symptoms, such as dizziness, vomiting, blurred vision, fits (seizures) and headaches.

With the right treatment virtually all children will become symptom free (remission) and 85% will be completely cured. Unfortunately, only about 40% of adult patients achieve a complete cure.

Treatment involves a combination of chemotherapy and radiotherapy (radiation therapy). Sometimes a bone marrow transplant may be used.

For those who are not cured, their immune systems, which are very low in white blood cells, become vulnerable to infections, some of them life-threatening. There is also a risk of serious bleeding due to a lack of platelets.

Approximately 230 people die from ALL in England and Wales each year.

Dutch athlete, Maarten van der Weijden, was diagnosed with ALL in 2001. He went on to win the 10 km open water marathon race at the 2008 Summer Olympics in Beijing.

Andrew McMahon, singer of the bands Something Corporate and Jack's Mannequin, was diagnosed with ALL in 2005.