Acute Lymphoblastic Leukemia
Original Editors - Erin Foster from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description
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Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow. Bone marrow is spongy tissue that fills the cavity of the long bones consisting of fat, red blood cells, and white blood cells. ALL affects the immature white blood cells. This type of cancer is classified by one of two subtypes.
The two subtypes include:
B-cell
- Common ALL (50% of cases)
- Early Pre-B ALL (10% of cases)
- Pre-B ALL (10% of cases)
- Mature B-cell ALL (4% of cases)
T-cell
- Pre-T ALL (5-10% of cases)
- Mature T-cell (15-20% of cases)
Prognostic factors include:
- Age
- White blood cell count
- ALL subtype
- Certain test results
- Response to treatment
Prevalence
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ALL is the most common cancer occurring in children today and can occur in some adult cases. Children are at the highest risk between 2 and 4 years of age. This risk decreases from age 4 to mid-20s, increasing again after age 50. The average person has a 1 in 1,000 chance of getting ALL. The American Cancer Society estimated the following statistics for 2010:
- Approximately 43,050 new cases of all types of leukemia.
- Approximately 5,330 new cases of acute lymphoblastic leukemia (1 out of 3 were adult cases).
- Approximately 1,420 deaths from ALL (3 out of 4 were adult cases).
Characteristics/Clinical Presentation[edit | edit source]
Most signs and symptoms of ALL mimic those of the flu. However, with ALL these signs and symptoms will not improve. Signs and symptoms include:
- Bleeding from the gums
- Nosebleeds
- Pale skin
- Shortness of breath
- Fever
- Frequent infections
- Weakness
- Fatigue
- Swollen lymph nodes (neck, underarm, groin, stomach)
Associated Co-morbidities[edit | edit source]
The following co-morbidities are linked to ALL:
- Anemia
- Diabetes
- Lupus
- Rheumatoid Arthritis
- Multiple Sclerosis
Medications[edit | edit source]
Medications involved with ALL include:
- Gleevec
- Adriamycin
- Purinethol
- Sprycel
- Trexall
- Oncaspar
- Arranon
- Clolar
- Vumon
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
Diagnostic tests and results for ALL include:
- Blood test
These tests reveal increased number of white blood cells, decreased number of red blood cells and platelets. A blood test may also reveal blast cells. Blast cells are immature blood cells in bone marrow.
- Bone marrow test
A needle is used to remove a sample of bone marrow from the hipbone to look for cancerous cells. Through this process, doctors can determine if the cells originated from the B lymphocytes or T lymphocytes according to certain changes in the cancer cells.
- Lumbar puncture or spinal tap
A sample of spinal fluid is collected to determine if the cancerous cells have spread.
- Imaging
X-ray and computerized tomography (CT) scan can help determine if the cancer has spread to other parts of the body.
Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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