Acute Lymphoblastic Leukemia (ALL)
Acute lymphoblastic leukemia (ALL), also called acute lymphocytic leukemia, is a cancer of the white blood cells. In ALL, the bone marrow (the soft, spongy center of bones) produces too many lymphocytes, a type of white blood cells that do not mature as they should. These leukemia cells do not fight infection well, and they crowd out the healthy blood cells and platelets.
Overview and Symptoms
Acute lymphoblastic leukemia is similar to acute myeloid leukemia (AML), except that AML affects the myeloid white blood cells instead of lymphocytes. Acute lymphoblastic leukemia survival rates vary significantly depending on the person’s age, ALL sub-type, and other factors.
ALL symptoms can include weakness, fever, anemia, bleeding or bruising, infections, and bone or joint pain. This type of cancer progresses quickly and symptoms may appear suddenly.
ALL diagnosis generally includes:
- a physical exam
- blood tests and evaluation
- diagnostic imaging for the evaluation and staging of your leukemia, such as a PET/CT scan. The PET/CT hybrid scanner is a state-of-the-art diagnostic imaging system that provides more precise information and localization for many cancers; and does it quicker than conventional PET imaging.
- biopsy — either a bone marrow biopsy to examine blood cells, or a surgical or CT-guided biopsy to obtain lymph node tissue samples. Usually biopsy procedures are not carried out at the initial visit, but arranged for a later date, once we have gathered your other information and imaging.
Leukemia Multidisciplinary Conference
At BIDMC, we review all of your information with the full blood cancer treatment team in our weekly multidisciplinary conferences. Our radiologists report on your imaging studies and our hematopathologists (pathologists who specialize in blood diseases) review the results of your biopsy. Hematologists, oncologists and radiation oncologists voice their opinions. Together as a team focused solely on you, we reach agreement on the best treatment options for your particular situation.
Acute Lymphoblastic Leukemia progresses rapidly, so once diagnosed, it should be treated quickly. The specific treatment you receive will depend on the sub-type of ALL you have, how far it has progressed when treatment starts, how the ALL responds to initial treatment, and other factors. It may include:
- Chemotherapy – the use of chemicals, through one or more types of medication, to treat disease. Chemotherapy interferes with cancer cells’ ability to grow. It can be administered intravenously (through an IV), subcutaneously (an injection below the skin), or orally (as a pill to swallow)
- Stem cell transplant – also called bone marrow transplant, in this procedure a donor's stem cells are transfused into your blood. The transplanted stem cells go from your blood to your bone marrow. Through this process, the cells that produced the abnormal cells are replaced with healthy cells that produce normal blood cells.
Types of bone marrow/stem cell transplants:
- Autologous stem cell transplants, which are stem cells that come from your own bone marrow or blood. Doctors extract stem cells from your blood or bone marrow, place them in frozen storage, and re-infuse them back into your body following high-dose chemotherapy to eliminate blood cancers.
- Allogeneic stem cell and bone marrow transplants, which are stem cells that come from matched related donors (siblings, for example), or from matched unrelated donors or donated umbilical cords. As a recognized site of the National Marrow Donor Program, BIDMC has access to an international registry of more than 5 million possible unrelated donors.
Dedicated Stem Cell Lab
Our stem cell/immunotherapy laboratory is a key component of our bone marrow transplantation service. The stem cell lab:
- Excels in the special and meticulous handling of human cells
- Provides expertise in the collection, storage, and manipulation of bone marrow and stem cell products so they are ready to be transplanted (re-infused) into the patient
Hematologic Malignancies/Bone Marrow Transplant (BMT) ProgramOur world-renown hematologists, oncologists, radiation oncologists, radiologists and hematopathologists provide state-of-the-art diagnosis and management for blood cancers, including ALL.