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Acute Lymphocytic Leukemia (ALL) in Adults

Medically reviewed by Last updated on Jun 12, 2024.

What is acute lymphocytic leukemia (ALL) in adults?

Harvard Health Publishing

Acute lymphocytic leukemia (ALL) is a type of leukemia. Leukemia is a cancer of the blood or bone marrow. ALL is also known as acute lymphoblastic leukemia and acute lymphoid leukemia.

ALL is a cancer of the body's blood-making system. Blood cells are produced in the bone marrow, the soft, inner part of bones.

The word "acute" in acute lymphocytic leukemia refers to the fact that the disease can progress quickly and that symptoms from the disease occur over a relatively short period of time. The word "lymphocytic" means that the cancer develops from lymphocytes, a type of white blood cell.

The body produces three types of infection-fighting lymphocytes:

In ALL, the body produces too many immature lymphocytes (lymphoblasts). These cells cannot fight infection as well as normal cells. Instead of maturing into adult lymphoid cells, these cells are immature cells and continue to grow and multiply as immature cells.

In addition, as these lymphocytes quickly multiply, they crowd out healthy white blood cells, red blood cells, and platelets in the blood and bone marrow. This may lead to infection, anemia, and easy bleeding.

Certain genetic changes are also associated with ALL.

Acute lymphocytic leukemia typically invades the blood quickly. It can involve other parts of the body, such as the lymph nodes, liver, spleen, brain and spinal cord (central nervous system), and testes.

Symptoms of acute lymphocytic leukemia (ALL) in adults

Among the possible signs and symptoms of ALL are:

Leukemia cells that spread to the brain and spinal cord can cause:

ALL is not a common disease in adults. So most often the above symptoms are caused by some other medical condition.

Most often the above symptoms are caused by some other condition, not ALL. However, you should always contact your doctor if you experience any of them.

Diagnosing acute lymphocytic leukemia (ALL) in adults

The first step in diagnosis is usually a physical examination and medical history. Your doctor will check for signs of disease. He or she will ask about your health habits and past illnesses and treatments.

To determine whether you have ALL, your doctor will also need to examine your blood and bone marrow, and possibly other cells and tissues. The following tests and procedures may be used:

These and other lab tests will help your doctor determine your subtype of ALL and your prognosis.

Once you have been diagnosed with ALL, you may need several additional tests and procedures. These will help determine whether the cancer has spread beyond the blood and bone marrow. The results will also help to plan a course of treatment. These additional tests are likely to include:

If you are diagnosed with leukemia, you may be referred to a hematologist/oncologist, a doctor who specializes in treating cancers and blood diseases.

Expected duration of acute lymphocytic leukemia (ALL) in adults

Acute lymphocytic leukemia usually gets worse quickly if not treated.

Preventing acute lymphocytic leukemia (ALL) in adults

There are no known ways to prevent ALL.

A few factors may increase a person's risk of developing ALL, but most are not avoidable. These include:

Having one or more of these risk factors does not mean you will develop ALL. Many people with the disease do not have any risk factors.

Treating acute lymphocytic leukemia (ALL) in adults

ALL is classified as:

There are usually two phases of treatment for adult ALL. The goal of the first treatment phase is to kill as many leukemia cells in the bone marrow, blood and fluid around the spinal cord and brain. This puts the disease into remission. The goal of the second phase is to kill any remaining leukemia cells that may not be active but which could begin to regrow and cause a relapse. The total treatment can take two or three years.

During these phases, patients also receive therapy to prevent or treat leukemia in the brain and spinal cord.

The major standard therapy for ALL is chemotherapy. Chemotherapy for ALL is usually given as combination chemotherapy. This means that more than one anticancer drug is used. Other treatments may be used under different circumstances.

Following are some of the commonly used treatments for ALL:

Stem cells (immature blood cells) are removed from the blood or bone marrow of a patient or donor. Once removed, they are examined under a microscope and the cell number is counted. The stem cells are stored for future use.

The patient then undergoes high-dose chemotherapy to eradicate the leukemic cells that populate the bone marrow. The stored stem cells are then infused into the patient's bloodstream. They migrate into the bone marrow space. Because these are stem cells, they are able to regenerate and grow into the many different cells that normally populate the bone marrow.

Stem cell transplants require very high dose chemotherapy to rid the body of all the leukemia. In the process, the patient cannot make any blood cells until the stem cells have had time to mature. This puts the patient at high risk of infection and bleeding. In addition to the short term risks, there are also long term side effects. Stem cell transplants should be undertaken only in specialized centers.

A new treatment approach for ALL is the use of so called CAR-T therapy. The patient's own blood cells are removed and then modified to allow them to identify the abnormal leukemia cells and eliminate them. While this therapy is still not yet FDA approved, it is likely to be approved soon.

Patients who have finished treatment should continue to see their doctors regularly for checkups. Some of the tests done to diagnose ALL may be repeated during and after treatment to see how well the therapy is working and/or whether your condition has changed.

Possible side effects of treatment

Some people receiving ALL treatment may experience no side effects. Others may face short-term or long-lasting side effects. Among the possible side effects of treatment are:

When considering a treatment option, it's important to ask your doctor about the expected benefits and risks of a particular therapy. How will this treatment affect my prognosis? What will my quality of life be during and after treatment?

Treatment options

The following list of medications are related to or used in the treatment of this condition.

View more treatment options

When To Call a Professional

Contact your doctor or healthcare provider if you experience any symptoms of ALL, such as:


The outlook for a person with ALL depends on several factors, including:

Additional Information

National Cancer Institute (NCI)

American Cancer Society (ACS)

Leukemia & Lymphoma Society

Learn more about Acute Lymphocytic Leukemia

Treatment options

Care guides

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.