Madisons Foundation - Moms And Dads In Search Of Needed Support

What

Acute lymphoblastic leukemia (ALL) is a disease of the white blood cells known as lymphocytes. lymphocytes normally help the body fight infection and are found in the blood, bone marrow, and other organs that are a part of the immune system. In ALL, functional lymphocytes are replaced by abnormal leukemic cells that grow quickly and accumulate in the bone marrow. As the number of healthy white blood cells diminishes, the child becomes susceptible to bleeding and infections.

Who

ALL can occur in children and adults. It is the most common cancer in children, representing 75-80% of the acute leukemias and 23% of all cancer diagnosis in children. Peak incidence in children occurs at the age of 4 years. Childhood ALL occurs slightly more often in boys than in girls, and more often in white children than in black children. Also, there is a higher rate of ALL in more developed countries and in higher socioeconomic groups. Approximately 6 out of 100,000 people have ALL.

Signs and Symptoms

An individual with ALL may exhibit some or all of the following symptoms: 1. Easy bleeding or bruising. 2. Bleeding gums with brushing or other forms of mild trauma 3. Frequent nosebleeds. 4. Abnormal menstrual periods. 5. Fatigue. 6. Shortness of breath during physical activity or exercise. 7. Pinpoint red spots (petechiae) and black-and-blue marks (bruises) on the skin. 8. Paleness. 9. Frequent infections with fever 10. Bone pain or tenderness in the breastbone area. 11. Joint pain: hip, knee, ankle, foot, shoulder, elbow, wrist, hand 12. Enlarged glands (lymphadenopathy). 13. Unintentional weight loss. 14. Sensation of feeling the heart beat (palpitations with an irregular pattern).

Possible Causes

The cause of ALL is currently unknown. However, certain factors put individuals at a greater risk for ALL. For example, individuals have a greater chance of developing ALL if they have Down and Bloom’s syndromes, an immunodeficiency disease (i.e. congenital hypogammaglobulinemia), a sibling with leukemia, or are exposed to radiation, certain chemicals, and drugs. Changes in genes and chromosomes may also contribute to the development of the cancerous white blood cells.

Diagnosis

ALL can be diagnosed through physical exam, blood tests, and examination of the bone marrow. Physical exam will show bruising, evidence of bleeding, and an enlarged liver and spleen. Relevant blood tests that are ordered include the complete blood cell count (CBC), electrolytes, and blood coagulation studies. The CBC may reveal a high or low white blood cell count, anemia, or low platelet levels. Electrolytes may show evidence of dehydration while coagulation studies can be abnormal in certain types of leukemia. bone marrow is usually extracted in order to confirm the presence of leukemic cells and to identify the subtype of leukemia in each patient. The leukemia cells are usually tested by a process known as immunophenotyping, which sorts the leukemia cells by specific immune markers on the cell surface. This information will be helpful during treatment decisions for the patient.

Treatment

The main treatment for ALL is chemotherapy, which consists of a combination of 3 to 8 anti-cancer medications. Chemotherapy is administered to kill the leukemic cells in the bone marrow, and is continued until the blood counts and bone marrow are normal. In the meantime, blood products (i.e. packed red blood cells, platelets) may need to be given to treat the anemia and low platelet count. platelets are important in blood clotting, and a low platelet count can lead to easy bleeding or bruising. Also, antibiotics can be given to treat any infections that develop. If chemotherapy does not work, a bone marrow transplant may be needed.

Prognosis

The overall cure rate for childhood ALL is approximately 80%. Therefore, children with ALL have a good chance of being cured or achieving complete remission of the disease.

Connect with other parents

In the spirit of community and support, Madisons Foundation offers the unique service of connecting parents of children with rare diseases. If you would like to be connected to other parents of children with this disease, please fill out this brief form.

Weblinks

American cancer Society
leukemia and Lymphoma Society: leukemia-l

National cancer Institute:

Questions and Answers About Care for Children and Adolescents with cancer

National cancer Institute : 

Google Search for Acute Lymphoblastic Leukemia (ALL)

References and Sources

Behrman, R., Kliegman, R., and H. Jenson. Nelson Textbook of Pediatrics. W.B. Saunder Co. 16th edition. 2000. pp.1543-1546. MedlinePlus: “Acute lymphocytic leukemia” www.nlm.nih.gov/medlineplus/ency/article/000541.htm National cancer Institute www.cancer.gov/newscenter/all3