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Home Cancer Leukemia Acute Lymphoblastic Leukemia (ALL)

Acute Lymphoblastic Leukemia (ALL)

Acute Lymphoblastic Leukemia is a form of cancer which affects the lymphocytes and lymphocyte producing cells in the bone marrow. Lymphocytes are white blood cells which produce antibodies and which are vital parts of the body’s immune system.

Normal lymphocytes are grouped into several different types with different functions. Very early lymphocytes have not yet committed themselves to become either T or B cells. One type of committed lymphocyte is called the B cell and is an antibody–producing cell. The antibodies which B–cells produce help to fight off infections. The other type of committed lymphocyte is the T cell which kills viruses, other infectious organisms and cells which are “Foreign” to the body.

It is important to know which type of lymphocytes the leukemia cells resemble because each type responds differently to treatment.
There are two major ways of describing the leukemia cells in ALL. These accounts look at different properties of the leukemia cells and are used together rather than as alternatives.

One of these systems is mainly based on the appearance of the leukemia cells under the microscope. This is described as the FAB classification after the group of French, American and British hematologists who designed the system.

The distinction between these two forms is of little significance to treatment or outcome. This form is similar to Burkitt’s lymphoma, and requires different treatment to other forms of ALL. The other main system is based on the type of lymphocyte affected, that is the B cell, the T cell or not definable as either which is called null cell.

The Immunological classification, i.e. T, B or null, together with the characterization of chromosome abnormalities are extremely useful in predicting the response to treatment.

If acute leukemia is not treated promptly, abnormal blood cells will quickly replace normal blood cell production. As a result, the patient will have severe anemia, bleeding and infections.

Without treatment, the condition can quickly become life–threatening. Patients with ALL have tests done as quickly as possible to confirm the diagnosis and to provide all the information to the doctors so that they plan the best possible treatment.

Usually, a patient will come under the care of a specialist unit where the medical and nursing staff have great experience in the treatment of leukemia. Treatment will normally begin within two or three days.

The aim of treatment is to get the patient into complete remission. Remission is a state in which the disease can no longer be detected by laboratory tests. If there is no trace of disease it is called a complete remission. If there is a marked improvement which falls short of complete remission this is called a partial remission. However, if all treatments were stopped as soon as remission was achieved, most patients would very quickly suffer a return of their leukemia (relapse).

Remission Induction
About 60–80% of adults with Acute Lymphoblastic Leukemia (ALL) will go into complete remission on the first course of treatment. They will have no signs or symptoms of the disease and all the laboratory tests will be normal.

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