What is Acute Lymphoblastic Leukemia (ALL)?

Acute Lymphoblastic Leukemia (ALL) is the most common cancer diagnosed in children. It accounts for 23% of cancer diagnoses in children under the age of 15, and roughly one in 29,000 children get ALL. It is a cancer that affects lymphoid cells of white blood cells, which when healthy, are responsible for fighting infections in the body. In those with this condition, these immature and malignant leukocytes, or white blood cells, multiply rapidly, overtaking and squeezing out healthy white and red blood cells in the blood. Because they are immature, the cancerous cells cannot fight off everyday infection, resulting in illness. If left untreated, this condition can be fatal.

These cancerous white blood cells tend to accumulate in the areas that comprise the central nervous system, such as the spinal cord and the brain. Once these cells have accumulated, symptoms begin to appear. Since ALL is often diagnosed in very young children, parents may not immediately notice the symptoms because they are not being communicated to them. Children who are diagnosed with this condition are typically anemic, and look tired and pale. They may also be weak, bruise easily, and have recurring fevers and infection, swollen lymph nodes, pain in the bones and joints, and headaches. Unfortunately, preventative screening for this condition is not available, so children cannot be diagnosed until the disease has taken hold.

When brought into their doctor with concerns of recurring infections and fever, the doctor will most likely run simple blood tests to determine the child’s blood cell count, and to examine the blood under a microscope. If the child is severely anemic, showing a possibility of ALL, further tests, including bone marrow testing and spinal taps, are conducted. Once the diagnosis is made, the doctor will make a determination of what type of ALL the child has. There are numerous subtypes of the disease, and diagnosing which type the child has will aid in determining his or her treatment and prognosis.

Doctors don’t know what causes this condition, or who is predisposed to developing it. X-ray exposure in the womb and Down Syndrome may be factors in its development. Boys have a higher rate of developing ALL than girls, and Caucasian boys are predisposed over African American boys.

Treatment of ALL is extensive and rigorous, sometimes lasting two to three years. Chemotherapy is the mainstay of a treatment program, and may be combined with a bone marrow transplant and radiation therapy, depending on the type of ALL, as well as the white blood cell count at the time of diagnosis.

The good news about this condition is that there are numerous clinical trials underway, and the prognosis for the vast majority of children diagnosed is positive. The five year survival rate is about 85%, and children diagnosed at one to nine years have the best chance of survival. Every year, the chances of a full recovery improve and this, along with competent care at a good facility, ensures that children have have a fighting chance at beating the disease.