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Acute lymphocytic leukemia - Highlights
- Highlights
- Introduction
- Causes
- Risk Factors
- Symptoms
- Diagnosis
- Prognosis
- Treatment
- Treatment to Achieve Remission
- Treatment During Remission
- Treatment After Relapse
- Home Management
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of leukemia.Alternative Names
Acute lymphoblastic (or lymphocytic) leukemia
Highlights:
Acute Lymphocytic Leukemia (ALL)
There are four major types of leukemia. ALL is the most common type of leukemia diagnosed in children, and the least common type diagnosed in adults. About 5,200 people are diagnosed with ALL each year. Children account for two-thirds of these cases. In general, children with ALL have a better prognosis than adults. Most children with ALL can be cured of this cancer.
Symptoms and Diagnosis
Symptoms of ALL include fatigue, pale skin, recurrent infections, bone pain, bruising, and small red spots under the skin. Doctors use various tests, including blood counts and bone marrow biopsies, to diagnose ALL.
Treatment
ALL is treated with chemotherapy and, sometimes, radiation. Children receive different types of chemotherapy regimens than adults. Patients with advanced cancer that has not responded to these treatments may need a stem cell transplant.
Infection Prevention
Both chemotherapy and transplantation increase the risk for infection. Patients must take serious precautions to avoid exposure to germs. Ways to prevent infection include:
- Practice good hygiene including regular handwashing and dental care (brushing, flossing)
- Avoid crowds, especially during cold and flu season
- Eat only well-cooked foods (no raw fruits or vegetables)
- Boil tap water before drinking it
- Do not keep fresh flowers or plants in your house as they may carry mold
- Make sure you are up to date with vaccinations. Children may need to be reimmunized
Resources
- www.leukemia-lymphoma.org -- Leukemia and Lymphoma Society
- www.cancer.org -- American Cancer Society
- www.cancer.gov -- National Cancer Institute
- www.marrow.org -- National Marrow Donor Program
- www.asco.org -- American Society of Clinical Oncology
- www.cancer.net -- Cancer.Net
- www.candlelighters.org -- Candlelighters Childhood Cancer Foundation
References
Belson M, Kingsley B, Holmes A. Risk factors for acute leukemia in children: a review. Environ Health Perspect. 2007 Jan;115(1):138-45.
Campbell LK, Scaduto M, Sharp W, et al. A meta-analysis of the neurocognitive sequelae of treatment for childhood acute lymphocytic leukemia. Pediatr Blood Cancer. 2007 Jul;49(1):65-73.
Campana D and Pui CH. Childhood Leukemia. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 101.
Hijiya N, Hudson MM, Lensing S, et al. Cumulative incidence of secondary neoplasms as a first event after childhood acute lymphoblastic leukemia. JAMA. 2007 Mar 21;297(11):1207-15.
Peterson CC, Johnson CE, Ramirez LY, Huestis S, Pai AL, Demaree HA, et al. A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia. Pediatr Blood Cancer. 2008 Jul;51(1):99-104.
Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. Lancet. 2008 Mar 22;371(9617):1030-43.
Ribera JM, Ortega JJ, Oriol A, et al. Comparison of intensive chemotherapy, allogeneic, or autologous stem-cell transplantation as postremission treatment for children with very high risk acute lymphoblastic leukemia: PETHEMA ALL-93 Trial. J Clin Oncol. 2007 Jan 1;25(1):16-24.
Thomas X, Dombret H. Treatment of Philadelphia chromosome-positive adult acute lymphoblastic leukemia. Leuk Lymphoma. 2008 Jul;49(7):1246-54.
Thomas X, Le QH. Central nervous system involvement in adult acute lymphoblastic leukemia. Hematology. 2008 Oct;13(5):293-302.
Trigg ME, Sather HN, Reaman GH, Tubergen DG, Steinherz PG, Gaynon PS, et al. Ten-year survival of children with acute lymphoblastic leukemia: a report from the Children's Oncology Group. Leuk Lymphoma. 2008 Jun;49(6):1142-54.
Waber DP, Turek J, Catania L, et al. Neuropsychological outcomes from a randomized trial of triple intrathecal chemotherapy compared with 18 Gy cranial radiation as CNS treatment in acute lymphoblastic leukemia: findings from Dana-Farber Cancer Institute ALL Consortium Protocol 95-01. J Clin Oncol. 2007 Nov 1;25(31):4914-21.
Yang JJ, Cheng C, Yang W, Pei D, Cao X, Fan Y, et al. Genome-wide interrogation of germline genetic variation associated with treatment response in childhood acute lymphoblastic leukemia. JAMA. 2009 Jan 28;301(4):393-403.
- Reviewed last on: 3/5/2009
- Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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