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Acute Lymphocytic Leukemia (ALL) in Children

Medically reviewed by Last updated on Jun 12, 2023.

What is acute lymphocytic leukemia (ALL) in children?

Harvard Health Publishing

Acute lymphocytic leukemia (ALL) is a cancer of the body's blood-making system. (It is also known as acute lymphoblastic leukemia and acute lymphoid leukemia.) The word "acute" refers to the fact that the disease can progress quickly. "Lymphocytic" means that the cancer develops from lymphocytes, a type of white blood cell.

Bone marrow, the soft inner part of bones, makes cells that circulate in the blood. They include white blood cells, red blood cells, and platelets. The two major types of white blood cells are myeloid cells and lymphoid cells. Lymphocytes populate lymph nodes, the spleen, the thymus and the gastrointestinal tract, where they provide immunity to aid in fighting infections.

Normally, the bone marrow makes three types of infection-fighting lymphocytes:

In ALL, the bone marrow makes too many immature lymphocytes. These lymphocytes, called blasts, contain abnormal genetic material. They cannot fight infections as well as normal cells. In addition, because these lymphocytes multiply quickly, 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.

The abnormal and immature lymphocytes that characterize ALL arise from the bone marrow typically are released into the blood stream quickly. It can involve other parts of the body, such as the lymph nodes, liver, spleen, brain and spinal cord (central nervous system), and testicles (testes).

Although it is rare in adults, ALL is the most common cancer in children. It can affect children of any age, but most are diagnosed between 2 and 4 years old.

A few factors may increase a child's risk of developing ALL. These include

Having one or more of these risk factors does not mean your child will develop ALL. Many children with the disease have no risk factors.

ALL has several subtypes. Subtypes depend on

Symptoms of acute lymphocytic leukemia (ALL) in children

The symptoms of ALL in children are similar to those in adults. They include

If your child has these symptoms, it does not mean that he or she has ALL. These symptoms can be caused by other conditions. However, you should contact your child's doctor if they occur.

Diagnosing acute lymphocytic leukemia (ALL) in children

The first step in diagnosis is usually a physical examination and medical history. Your child's doctor will check for signs of disease, such as lumps in the neck. He or she will ask about your family's medical history and your child's past illnesses and treatments.

To determine whether your child has ALL, the doctor will also need to test your child's blood and bone marrow, and possibly other cells and tissues. The following tests and procedures may be used:

These and other lab tests can also help determine the subtype of ALL.

If your child is diagnosed with ALL, the doctor may suggest other 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. Additional tests are likely to include:

There are two main risk groups for childhood ALL. They are based on age and white blood cell counts at diagnosis. The risk groups are standard (low) risk and high risk. The risk level helps determine the best treatment.

Children with ALL should be cared for by a team with expertise in childhood leukemia. Long-term, regular follow-up exams are very important as well. This is because treatment for childhood ALL can have long-term effects on learning, memory, mood, and other aspects of health. It can also increase the chance of developing new cancers, especially brain tumors.

Expected duration of acute lymphocytic leukemia (ALL) in children

ALL usually gets worse quickly if not treated.

Preventing acute lymphocytic leukemia (ALL) in children

There are no known ways to prevent ALL.

Treating acute lymphocytic leukemia (ALL) in children

Treatment of childhood ALL usually occurs in phases:

In addition, children with ALL usually receive therapy to prevent or treat leukemia in the brain and spinal cord.

Your child will have bone marrow aspirations and biopsies throughout treatment. These tests show how well the cancer is responding to treatment.

The type of treatment varies depending on the child's age, disease subtype, and risk group (standard/low risk or high risk). Four types of treatment are used for childhood ALL:

Children with ALL often receive high doses of corticosteroids, such as prednisone or dexamethasone. These drugs can cause a variety of side effects including weight gain, a puffy face and high blood sugar levels.

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.

Some children receiving ALL treatment experience no side effects, but others do. Side effects vary, depending on the treatment. They may include

There are many ways to manage side effects. For example, regular hand washing can help lower the risk of infection.

Your child will need regular checkups after he or she has finished treatment. Some of the tests done to diagnose ALL may be repeated to monitor your child's health and see whether the cancer has returned.

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 notice any symptoms of ALL in your child. These include


The outlook for childhood ALL depends on

Survival rates for children with ALL have risen over time, thanks to advances in treatment. More than 85% of children with ALL live at least five years.

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.