What is acute lymphoblastic leukemia (ALL)?

Acute lymphoblastic leukemia, or ALL, is a type of blood cancer that begins in the bone marrow when the body produces large numbers of immature lymphocytes, a type of white blood cell. These abnormal cells grow rapidly and can crowd out healthy blood-forming cells in the bone marrow, leading to reduced production of normal blood cells. ALL is the most common type of leukemia in children, but it can also occur in adults. It can worsen quickly without treatment, so suspected ALL requires prompt medical assessment. [1] [2]

How does acute lymphoblastic leukemia begin?

ALL develops in blood-forming cells in the bone marrow when changes cause some immature lymphocytes to grow and multiply abnormally. Because these cells can multiply quickly, they may accumulate in the bone marrow and interfere with production of red blood cells, platelets, and normal white blood cells. Abnormal cells can also move outside the bone marrow into the blood, lymph nodes, or other organs. The characteristics of ALL differ between children and adults and among its subtypes, so diagnosis and classification depend on specialized laboratory testing. [1] [3]

What symptoms can occur?

Symptoms often result from reduced production of normal blood cells or the spread of abnormal cells. Fatigue, weakness, or paleness can occur because of anemia, while infections or fever can occur when normal white blood cells are reduced. Easy bleeding or bruising can result from a low platelet count. Other possible symptoms include bone or joint pain, enlarged lymph nodes or enlargement of the liver or spleen, and loss of weight or appetite. These signs are not specific to ALL, so the disease cannot be diagnosed from symptoms alone. [1] [3]

How is ALL diagnosed?

Evaluation when ALL is suspected generally begins with blood tests, which may show abnormal blood-cell counts or abnormal cells. Diagnosis may require examination of the bone marrow to identify the abnormal cells, along with specialized tests that help determine the type of leukemia and its genetic or molecular characteristics. This information is important for classifying the disease and selecting an appropriate treatment plan. A single blood-test result is therefore not enough to prove or exclude ALL, and the subtype cannot be determined from symptoms alone. [1] [2]

How is ALL treated?

Treatment depends on multiple factors, including age, the type of ALL, cell characteristics, response to treatment, and other findings from diagnostic testing. Sources explain that ALL treatment can involve multiple phases and aims to eliminate leukemia cells and prevent them from returning in the bone marrow or other locations. Options may include chemotherapy and targeted or immunotherapy approaches in selected types or situations, while stem cell transplantation may be considered for some patients based on specialist assessment. Treatment plans can differ substantially between children and adults and between individual cases, so there is no single treatment plan that applies to everyone. [2] [3] Acute Lymphoblastic Leukemia ALL: Early Diagnosis and Treatment in Children and Adults (Arabic)

Medical references

• Acute Lymphocytic Leukemia
• Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version
• Acute lymphocytic leukemia (ALL)