Leukemia is a deadly disease that affects nearly 50,000 people within the United States every year, and accounts for 65% of all childhood cancers in the US. Acute lymphoblastic leukemia (ALL) has a peak incidence between 2 and 5 years of age, and is the least common type of leukemia found in adults, according to a WebMD publication.  Although relatively curable in children, ALL is much more difficult to treat in adults.

This blood cancer is caused when white blood cells in the bone marrow deform and travel throughout the body. Specifically, ALL forms from cells called lymphocytes and lymphoblasts, which are part of the body’s immune system.

ALL can expand throughout the human body and invade organs like the spleen, liver, and lymph nodes. This type of cancer is deadly as it can progress quickly and, without treatment, lead to fatality within several months.

In a patient diagnosed with ALL, a high amount of stem cells turn into lymphoblasts, B lymphocytes, or T lymphocytes, which normally fight infection. However, these leukemia cells do not work effectively and are unable to fight infection well, according to a publication from the National Cancer Institute.

Survival from this disease depends upon age, any chromosomal abnormality, lab test results, and response to chemotherapy. A mutation called the Philadelphia chromosome leads to a poorer prognosis while having a lower white blood count at diagnosis could lead to a better outcome. There are a number of chromosomal translocations associated with ALL, but the most common is a translocation between chromosomes 12 and 21 (t(12;21), which occurs in approximately 25% of ALL patients.

At this point in time, there are several classification systems for ALL, reflecting the diversity of the disease, and the fact that we have not identified a clear cause of acute lymphoblastic leukemia. There are known risk factors that increase the likelihood of the illness including; exposure to a high amount of radiation, Trisomy 21, exposure to chemicals like benzene, cleaning agents, and cigarette smoke.

In addition, infection with human T-cell lymphotropic viruses (HTLV-I and HTLV-II).  HTLV- I and HTLV-II are transmissible agents distantly related to HIV-1, that causes adult T-cell leukemia (a subset of ALL) in approximately 5% of the individuals infected with the virus. Childhood ALL is most prevalent in Spain and among Hispanic populations in Costa Rica and Los Angeles. White males are at higher risk of contracting ALL during adulthood, due to increased exopusure to environmental carcinogens.

Some of the symptoms of this cancer are fatigue, dizziness, lightheadedness, shortness of breath, overheating/sweating, fever, and loss of appetite and weight. This disease could also lead to a shortage of platelets, which causes bruising, nosebleeds, bloody gums, bone and joint pain, enlarged lymph nodes, vomiting, seizures, and headaches.

Treatment for ALL depends upon the subtype of the disease, but chemotherapy drugs such as methotrexate and cyclophosphamide are commonly used in these cases. Targeted therapies using medications like ponatinib, imatinib, and dasatinib are also beneficial in treating this disease. Targeted therapy actually has fewer side effects than chemotherapy, which may be a better choice for various patients.

Radiation therapy is another option, but is usually only used to destroy cancerous cells in the brain or bones before a stem cell transplant. A bone marrow transplant is used in severe cases — however, several doses of chemotherapy and radiation are necessary before a bone marrow transplant can occur. While approximately 90 percent of patients make it to remission, many have a recurrence, which lowers the survival rate of adult ALL to roughly 30 to 40 percent. In children, approximately 80% make a complete recovery. Both of these figures represent dramatic improvements over the situation only 20 or so years ago.

The research sector is determined to improve these dismal statistics, including the use of tumor models to study innovative cancer drugs that treat a variety of different cancers including leukemia.

Post Highlights

• This blood cancer is caused when white blood cells in the bone marrow deform and travel throughout the body.
• Targeted therapies using medications like ponatinib, imatinib, and dasatinib are also beneficial in treating this disease.
• Several doses of chemotherapy and radiation are necessary before a bone marrow transplant can occur.

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Categories: Oncology

Tags: Acute Lymphoblastic Leukemia, ALL, blood cancer, cancer, leukemia