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Acute Lymphocytic Leukemia, Ambulatory Care

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.

Common symptoms include the following:

  • 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

Call 911 for any of the following:

  • Warm, tender, swollen, red, and painful arm or leg
  • Feeling lightheaded and short of breath, with chest pain
  • Coughing up blood

Seek care immediately for the following:

  • A headache, stiff neck, or trouble seeing or thinking clearly
  • A fever after you received chemotherapy in the last 2 weeks

Treatment for ALL

may happen 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.

Manage your 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.

Follow up with your healthcare provider as directed:

You will need to see your oncologist for ongoing treatment. Write down your questions so you remember to ask them during your visits.

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.

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