Acute Lymphocytic Leukemia

What is acute lymphocytic leukemia?

Acute lymphocytic leukemia (ALL), or acute lymphoblastic leukemia, is cancer of the blood cells. Lymphocytes are a type of white blood cell (WBC). A person with ALL makes more lymphocytes than his body needs. The abnormal lymphocytes are called lymphoblasts (leukemia cells). Lymphoblasts do not fight infection like normal WBCs. They crowd the bone marrow and prevent normal blood cells from growing and fighting infection.

What causes ALL?

The exact cause of ALL is not known. It is most common among children younger than 10 years. The following may increase your risk for ALL:

  • Exposure to high amounts of radiation, certain medicines, or chemicals

  • Age older than 50 years

  • Down syndrome

  • A brother or sister has leukemia

What are the signs and symptoms of ALL?

  • Easy bleeding or bruising

  • Abdominal, bone, or joint pain or headaches

  • Frequent illnesses, such as colds, coughs, or the flu

  • Swollen lymph nodes in your neck, armpits, or groin

  • Shortness of breath or feeling very tired

  • Fever

  • Weight loss without trying

  • Night sweats

How is ALL diagnosed?

  • Blood tests may be done to count the number of each type of blood cell (RBCs, WBCs, platelets).

  • A bone marrow biopsy is a procedure to take a small amount of bone marrow from the bone in your hip. This test helps healthcare providers find out which type of leukemia you have.



  • A lumbar puncture is a procedure to remove fluid from around your spinal cord to be tested. Treatment may also be given.

How is ALL treated?

You may get treatment in phases. In the first phase, healthcare providers will give you treatments to make your ALL go into remission. Remission means there are no longer any signs of leukemia. After you are in remission, you will get the next phase of treatment, called postremission treatment. The goal of this phase is to kill any hidden leukemia cells and help you stay in remission. Treatment may include the following:

  • Chemotherapy is used to kill cancer cells. Your healthcare provider may give you 2 or more kinds of chemotherapy.

  • Radiation therapy shrinks tumors and kills cancer cells with x-rays or gamma rays. It may be given alone or with chemotherapy to treat cancer.

  • A transplant may be part of your postremission treatment. Bone marrow or stem cells are put in your blood through an IV. The stem cells go to your bone marrow and begin to make new blood cells.

What can I do to manage my ALL?

  • Prevent infection. Wash your hands often, avoid people who are sick, and clean humidifiers daily. Ask your healthcare provider for more information on preventing infection.

  • Prevent bleeding and bruising. Be careful with sharp or pointed objects, such as knives and toothpicks. Do not play contact sports, such as football. Use a soft toothbrush. Do not floss your teeth while your platelet count is low. Blow your nose gently. Your nose may bleed if you pick it. Do not take NSAIDs or aspirin. NSAIDs and aspirin thin your blood and increase your risk for bleeding.

  • Do not smoke cigarettes or drink alcohol. Alcohol can thin your blood and make it easier to bleed. Smoking increases your risk for new or returning cancer. Smoking can also delay healing after treatment. Ask your healthcare provider for information if you currently smoke or drink and need help quitting.

  • Drink liquids as directed. You may need to drink extra liquids to prevent dehydration, especially if you are vomiting or have diarrhea from cancer treatments. Ask how much liquid you need each day and which liquids are best for you.

  • Exercise as directed. ALL or its treatment may make you feel tired. Exercise can help you have more energy.

  • Eat healthy foods. Healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your healthcare provider if you have problems eating, or if you are nauseated.

Call 911 for any of the following:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

When should I seek immediate care?

  • You have a headache, stiff neck, or have trouble seeing or thinking clearly.

  • You received chemotherapy in the last 2 weeks and you have a fever.

When should I contact my healthcare provider?

  • You see blood in your spit or vomit.

  • You have coughing or shortness of breath.

  • You feel dizzy or have a fast heartbeat.

  • You have sores or white patches in your mouth or throat.

  • You have rectal pain or hemorrhoids.

  • You have diarrhea or bloody bowel movements.

  • You have pain in your eyes, ears, skin, joints, or stomach.

  • You have pain when you urinate, or bad-smelling urine.

  • You have frequent nosebleeds, or your gums bleed.

  • You have blurred vision, or blood spots in the whites of your eyes.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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