Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is a rare blood malignancy that attacks white blood cells known as lymphocytes. ALL can affect anyone of any age, although children under the age of 15 and adults over the age of 50 are more likely to develop the disorder. While ALL is a serious disorder, modern treatments, such as long-term chemotherapy, can cure children with the disease, and others are living longer lives with it.

Symptoms

Most symptoms appear abruptly and affect both children and adults. Common early symptoms include:

• Anemia.
• Bleeding, such as frequent nosebleeds or heavy menstrual periods.
• Bruising.
• Cough.
• Dizziness.
• Fatigue.
• Fever.
• Frequent viral infections or bacterial infections.
• Joint pain.
• Loss of appetite.
• Night sweats.
• Red, pinhead-sized spots on your skin (petechiae).
• Shortness of breath.
• Skin color thats paler or lighter than usual.
• Swollen lymph nodes.
• Unexplained weight loss.
• Weakness.

Causes

Researchers continue to identify genetic mutations (changes) that cause ALL. Young children with ALL may have experienced genetic alterations before birth. Some people have ALL because they inherited conditions that raise their risk of contracting the disease. ALL in adults has been associated to several carcinogens, especially tobacco.

Diagnosis

Your healthcare professional assesses your symptoms, checks your medical history, and conducts a physical examination. If they suspect ALL, they may perform the following tests, including those for genetic changes:

• Complete blood count (CBC).
• Bone marrow biopsy.
• Lymph node biopsy.
• Lumbar puncture (spinal tap).
• Magnetic resonance imaging (MRI) scan.
• Computed tomography (CT) scan.
• Positron emission tomography (PET) scan.
• Flow cytometry to determine ALL sub-type.
• Cytogenetic tests to examine cells chromosomes.
• Molecular assays to check for certain genes, proteins or other molecules that may be signs of ALL.

Treatment

ALL can be treated with long-term chemotherapy, targeted therapy, immunotherapy, or stem cell (bone marrow) transplantation. Adults and children with ALL may receive different cancer medications and treatments.

Chemotherapy

Chemotherapy is used as an initial or first-line treatment for ALL. People with ALL get chemotherapy in four stages. The therapy goal is to put everyone into complete remission. (Complete remission occurs when treatment eliminates your symptoms and testing reveal no evidence of cancer.) Chemotherapy for ALL usually lasts several months, if not years, and involves high dosages of cancer-killing medicines. Patients taking chemotherapy for ALL should consider palliative care to assist in alleviating treatment adverse effects. ALL chemotherapy includes:

• Remission induction therapy eliminates as many leukemia cells as feasible, resulting in complete remission. People are typically hospitalized during remission induction therapy. This treatment lasts four to six weeks. According to studies, about 95% of children and 75% to 80% of adults with ALL will achieve complete remission following remission induction therapy.
• Central nervous system-directed therapy to eliminate all leukemia cells in your central nervous system and prevent them from spreading to your spinal fluid. (System-directed chemotherapy treats your complete body or system.)
• Once ALL has gone into remission, consolidation therapy can begin. This treatment aims to eliminate as many leftover malignant cells as feasible. Consolidation therapy entails spending several months in the hospital while receiving high-dose chemotherapy once a week.
• Continuation or maintenance therapy is a long-term treatment that can last two or three years. You do not need to be in the hospital to obtain maintenance therapy.

Targeted therapy: Targeted therapy targets certain genetic alterations. Chromosomal mutations occur in approximately 25% of adults and some children with ALL. Tyrosine kinase (TKI) therapy is now used in the treatment of ALL in children and adults with a specific mutation known as the Philadelphia chromosome. TKI treatment inhibits an enzyme necessary for ALL development. TKI therapy eliminates all cells, allowing your body to return to normal blood cell production.

Immunotherapy: Immunotherapy stimulates your body's own immune system to attack cancer cells. CAR-T cell or monoclonal antibody therapy may be used as immunotherapy for ALL.

Radiation therapy: To treat recurrent ALL or ALL that has not responded to chemotherapy, healthcare providers may recommend radiation therapy. Recently, doctors have employed radiation therapy to treat ALL that has spread (metastasized) to people's brains or spinal fluid.

Allogeneic stem cell (bone marrow) transplantation: When other treatments fail to remove ALL, a healthcare provider may recommend allogeneic stem cell (bone marrow) transplantation to people with acute lymphoblastic leukemia.

Prevention

No, it cannot. Children with ALL develop the disorder as a result of genetic alterations that occurred prior to their birth. However, adults with ALL may be able to reduce their risk by avoiding carcinogens like nicotine and hazardous chemicals.

Conclusion

Acute Lymphoblastic Leukemia (ALL) is a fast-growing blood malignancy that requires early treatment. While the disease can be severe, advances in treatments, including chemotherapy, stem cell transplants, and targeted therapies, have significantly improved survival rates, particularly in youngsters. Early detection and treatment are critical to better outcomes, so if you or someone you know is suffering symptoms such as exhaustion, fever, unexplained bruises, or enlarged lymph nodes, seek medical assistance right away. Many people who have been diagnosed with ALL can achieve remission and live normal lives if they take the appropriate approach. Visit SHALBY Sanar International Hospitals to learn more.