Acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). It may develop in children or adults. ALL spreads to the blood fairly quickly, and then may spread to other areas of the body such as the lymph nodes, liver, spleen, central nervous system, and testicles (in males). Signs and symptoms of ALL may include fever, easy bruising or bleeding, feeling tired, loss of appetite, pain in the bones or abdomen, and painless lumps in the neck, underarm, stomach, or groin.

ALL is typically caused by random, non-inherited changes in the DNA of immature lymphocytes called lymphoblasts. However, some people may inherit a genetic susceptibility to developing ALL. The risk to develop ALL may also be increased by past treatment for cancer, and by having certain genetic conditions or syndromes. Having one or more risk factors does not mean that a person definitely will develop ALL.

Treatment of ALL depends on the person's age, how advanced the cancer is, and whether certain genetic changes are found in cancer cells. Treatment options may involve systemic and/or intrathecal chemotherapy, radiation therapy, targeted therapy, and/or a stem cell transplant. Biologic therapy and chimeric antigen receptor (CAR) T-cell therapy are currently being studied as treatment options and may be used when other therapies are not working.

The chance of recovery also depends on many factors. With treatment, about 98% of children with ALL go into remission, and 85% of those with first-time ALL are expected have no long-term complications. The chance of recovery for adults is not as high, as 20-40% of adults are cured with current treatments.