Acute Lymphoblastic Leukaemia (ALL)
Acute lymphoblastic leukaemia (ALL) is a type of cancer that affects the blood and bone marrow. It is characterised by the overproduction of immature white blood cells called lymphoblasts. ALL is the most common type of cancer in children but it can also occur in adults.
Illness and Conditions
ALL is a rapidly progressing disease that impacts the lymphoid line of blood cells. The excessive lymphoblasts crowd out normal cells in the bone marrow, leading to a deficiency of healthy blood cells—this results in anaemia, increased risk of infection, and bleeding problems. The disease can spread to other organs including the lymph nodes, liver, spleen, and central nervous system.
Symptoms
Symptoms of ALL often develop quickly and can include:
- Fatigue and weakness due to anaemia
- Frequent infections because of a low white blood cell count
- Easy bruising or bleeding, such as nosebleeds and bleeding gums
- Bone and joint pain
- Swollen lymph nodes, liver, or spleen
- Fever and night sweats
- Weight loss and loss of appetite
- Shortness of breath
Causes
The exact cause of ALL is not fully understood. However, several factors may increase the risk:
- Genetic mutations in blood cell precursors
- Exposure to high levels of radiation or certain chemicals
- Previous chemotherapy or radiation therapy for other cancers
- Certain genetic disorders like Down syndrome
- Family history of leukaemia
Diagnosis
Diagnosis of ALL involves several steps:
- Blood tests to check for abnormal white blood cells and low counts of red blood cells and platelets
- Bone marrow biopsy to confirm the presence of lymphoblasts and determine the subtype of ALL
- Lumbar puncture to check for leukaemia cells in the cerebrospinal fluid
- Imaging tests such as X-rays or CT scans to detect spread to other organs
- Genetic and molecular testing to identify specific mutations that may influence treatment
Treatment
Treatment for ALL typically involves several phases:
- Induction therapy to kill leukaemia cells and achieve remission
- Consolidation or intensification therapy to eliminate remaining leukaemia cells
- Maintenance therapy to prevent relapse, often lasting 2-3 years
- Central nervous system prophylaxis using intrathecal chemotherapy to prevent spread to the brain and spinal cord
Additional treatments may include:
- Targeted therapy based on genetic abnormalities
- Stem cell or bone marrow transplantation in high-risk or relapsed cases
- Supportive care such as antibiotics, blood transfusions, and growth factors
Prevention
There is no guaranteed way to prevent ALL, but some measures may reduce risk:
- Avoiding exposure to high levels of radiation and harmful chemicals
- Using protective measures if undergoing radiation or chemotherapy for other conditions
- Regular medical check-ups for early detection if at high risk
Early diagnosis and advances in treatment have significantly improved the prognosis of ALL, especially in children. Prompt medical attention for symptoms and adherence to treatment protocols are essential for the best outcomes.