Acute Lymphoblastic Leukemia (A.L.L.)
Acute Lymphoblastic Leukemia (A.L.L.)
Children’s Mercy Hospital
The Facts
* ALL is a form of cancer that affects the lymphoid cells of the blood and bone marrow.
* In leukemia, the bone marrow produces an overabundance of underdeveloped white blood cells (leukemia cells) that cannot perform their usual function of fighting infection.
* When the leukemic cells fill the marrow, production of healthy red cells, platelets and white cells decreases causing anemia, bleeding and infection.
* The exact cause of childhood leukemia is unknown, but it is thought that certain genetic factors, along with environmental, immunologic and possibly viral factors predispose individuals to leukemia.
* Leukemia is the most common form of childhood cancer and ALL comprises about 70% to 75% of acute leukemias in this age group.
* Approximately 3000 children are diagnosed with ALL each year.
* ALL is diagnosed most frequently in children 3-5 years of age.
* Almost all children with ALL can be treated effectively with chemotherapy and probably more that 75% can be cured.
Symptoms
The most common signs and symptoms seen with ALL reflect the abnormal blood cell production in the bone marrow.
* Excessive fatigue and weakness caused by lack of healthy red cells
* Pain in bones and joints of the arms and legs caused by the bone marrow filling with leukemia cells
* Excessive bruising, bleeding and petechiae caused by lack of platelets
* Persistent infections and fever caused by lack of healthy white cells
Diagnosis
A physician may suspect the diagnosis of leukemia by their history and physical exam, but it can only be confirmed by laboratory tests.
* Complete Blood Count (CBC) to measure the different kinds of blood cells and hemoglobin level
* Blood smear to visualize the appearance of the cells under a microscope
* Bone Marrow Aspirate to distinguish what type of leukemia is present
* Chromosome Analysis to predict a likely response to certain treatments
Treatment
* Chemotherapy – the use of various drugs to destroy the abnormal leukemic cells
* Radiotherapy – Radiation may be used on the brain and spinal cord to treat or prevent the spread of leukemic cells to the central nervous system. Only a small percentage of children require radiation.
* Bone marrow transplantation – currently being studied in clinical trials for children who fail to enter remission or who relapse
Common Chemotherapy Agents
* Vincristine
* Dexamethasone
* Daunorubicin
* L-aspariginase
* Ara-C
* Methotrexate
* Mercaptopurine
* Thioguanine
* Cyclophosphamide
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