Acute Lymphoblastic Leukemia (ALL)

Acute Lymphoblastic Leukemia (ALL)

About Leukemia

Leukemia is a type of cancer that affects the body's white blood cells (WBCs).

Normally, WBCs help fight infection and protect the body against disease. But in leukemia, WBCs turn cancerous and multiply when they shouldn't, resulting in too many abnormal WBCs, which then interfere with organ function.

If too many lymphoblasts (a certain type of WBC) are produced, a child will develop acute lymphoblastic, or lymphoid, leukemia (ALL). This is the most common type of childhood leukemia, affecting about 75% of kids with this cancer of the blood cells. Kids ages 2 to 8 are more likely to be affected, but all age groups can develop ALL.

Thanks to advances in therapy and clinical trials, the outlook for kids with ALL is promising. With treatment, about 85% are cured.

Causes

The cause of ALL is not known. However, certain risk factors might increase a child's chance of developing it.

Kids with an identical twin who was diagnosed with the illness before age 6 have a 20% to 25% chance of developing ALL. Fraternal twins and other siblings of children with leukemia have two to four times the average risk of developing it, too.

Children who have inherited certain genetic problems (such as Li-Fraumeni syndrome, Down syndrome, Klinefelter syndrome, neurofibromatosis, ataxia telangiectasia, or Fanconi anemia) also have a higher risk of developing leukemia, as do those who are receiving medicines to suppress their immune systems after organ transplants.

Kids who have received radiation or chemotherapy for other types of cancer also have a higher risk, usually within the first 8 years after treatment.

In most cases, however, neither parents nor children have control over the factors that trigger leukemia. Current studies are investigating the possibility that some environmental factors may predispose a child to develop the disease. For example, prenatal radiation exposure (such as X-rays) may trigger ALL in a developing fetus. Women who are pregnant (or suspect they're pregnant) should inform their doctors before undergoing tests or medical procedures that involve radiation.

Signs and Symptoms

All types of leukemia generally have the same symptoms, which include:

Diagnosis

The subtypes of ALL are classified according to the proteins found in the leukemia cells. This requires special tests. A doctor who suspects a child has leukemia might order these tests:

Treatment

Most children with ALL are treated with chemotherapy (the use of special drugs to kill cancer cells). What drugs are used and in what combination will depend on which subtype of ALL is present and how aggressive the disease is.

Chemotherapy can be given intravenously as an injection into a muscle or orally in pill form. In intrathecal (IT) chemotherapy, a spinal tap is used to deliver chemotherapy drugs directly to the cerebrospinal fluid, where cancerous WBCs can collect.

After treatment begins, the goal is remission (when there is no longer evidence of cancer cells in the body). Once remission has occurred, chemotherapy is usually used to keep the child in remission.

Maintenance chemotherapy is given in cycles over a period of 2 to 3 years to keep the cancer from recurring. Leukemia will almost always relapse (recur) if this additional chemotherapy isn't given. Sometimes the cancer will return in spite of maintenance chemotherapy, and other forms of chemotherapy will be necessary.

Some more aggressive forms of ALL might require a stem cell transplant (sometimes called a bone marrow transplant). This procedure involves destroying cancer cells and normal bone marrow and immune system cells with high-dose chemotherapy and then re-introducing healthy donor stem cells into the body. The new stem cells can rebuild a healthy blood supply and immune system.

If a child needs a stem cell transplant, a test (called tissue typing or HLA [human leukocyte antigen] typing) will be done to help doctors find a suitable stem cell donor. This works by comparing the proteins on the surface of a child's blood cells with the proteins on a potential donor's cells. The more "HLA markers" a child and donor share, the greater the chance that the transplant will be successful.

Coping

Being told that a child has cancer can be a terrifying experience, and the stress of cancer treatment can be overwhelming for any family.

Although you might feel like it at times, you're not alone. To find out about support that may be available to you or your child, talk to your doctor or a hospital social worker. Many resources are available that can help you get through this difficult time.

Reviewed by: Christopher N. Frantz, MD
Date reviewed: October 2012





Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2014 The Nemours Foundation/KidsHealth. All rights reserved.





Bookmark and Share

Related Resources
Web SiteCureSearch for Children's Cancer CureSearch for Children's Cancer supports and sponsors research and treatment for childhood cancers.
OrganizationAmerican Cancer Society The American Cancer Society is the nationwide community-based voluntary health organization dedicated to preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy, and service. Call:(800) ACS-2345
OrganizationNational Marrow Donor Program (NMDP) The NMDP is a nonprofit organization that facilitates unrelated marrow and blood stem cell transplants for people with life-threatening diseases who do not have matching donors in their families.
Web SiteAlex's Lemonade Stand Foundation for Childhood Cancer A unique foundation that evolved from a young cancer patient's front-yard lemonade stand to a nationwide fundraising movement to find a cure for pediatric cancer.
Web SiteNational Cancer Institute (NCI) NCI provides detailed information about cancer research, various kinds of cancer, and living with cancer. Call: (800) 4-CANCER
OrganizationLeukemia & Lymphoma Society The Leukemia & Lymphoma Society is dedicated to funding blood-cancer research, education, and patient services. The Society's mission is to cure leukemia, lymphoma, Hodgkin's disease, and myeloma, and to improve the quality of life of patients and their families. Call: (914) 949-5213
Related Articles
Leukemia Leukemia refers to cancers of the white blood cells (also called leukocytes or WBCs). With the proper treatment, the outlook for kids who are diagnosed with leukemia is quite good.
Types of Cancer Teens Get While cancer is rare in teens, some types are more likely to affect young people. Learn about these types of cancer, including warning signs, symptoms, and treatments.
When Cancer Keeps You Home Sometimes kids who have cancer need to stay home instead of going to school and doing their normal stuff. Find out why and what kids can do in the meantime.
Neutropenia Certain types of cancer, or cancer treatment, can weaken the immune system, requiring a child to stay home to avoid exposure to germs. Here are ways to help your child make the best of being at home.
Acute Myeloid Leukemia (AML) Among kids with leukemia, 20% have this form of the blood cancer. With treatment, most recover.
Chronic Myelogenous Leukemia (CML) While this type of blood cancer is more common in adults, it affects children, too. Thanks to advances in therapy, most kids with CML can be cured.
Cancer Center Visit our Cancer Center for teens to get information and advice on treating and coping with cancer.
Cancer Center From treatments and prevention to coping with the emotional aspects of cancer, the Cancer Center provides comprehensive information that parents need.
Cancer: DJ's Story (Video) Leukemia survivor DJ talks about coping with cancer in this video for teens.
When Cancer Keeps You Home Cancer patients often have to stay at home to avoid infection. Read our ideas on ways to make the best of your time at home.
Stem Cell Transplants Stem cells can develop into cells with different skills, so they're useful in treating diseases like cancer.
Stem Cell Transplants Stem cells help rebuild a weakened immune system. Stem cell transplants are effective treatments for a wide range of diseases, including cancer.
Chemotherapy Chemotherapy is a big word for treatment with medicines used to help people who have cancer. This medicine kills the cancer cells that are making the person sick.
Cancer: Parents Talk (Video) Four sets of parents - all of whom have children who survived cancer - talk about their kids' journey as well as their own.
Cancer Center Cancer is a serious illness that needs special treatment. Find out more about how kids can cope with cancer.
iGrow iGrow
Sign up for our parent enewsletter