Acute Lymphoblastic Leukaemia, also referred to as ALL, is a type of blood cancer, also known as Acute lymphoid leukaemia and acute lymphocytic leukaemia. Its roots lie in the white blood cells (WBCs), found in the bone marrow. Though predominantly a blood cancer, ALL can spread to organs like the liver, the lymph nodes and the spleen. While ALL is the least common kind of cancer affecting adults, among children it is the most prevalent.
Patients with ALL may have one or more of the following symptoms:
Bleeding - skin bruising, bleeding from nose and gums
Bone pain - children may have limping or may refuse to walk
Swollen lymph glands
Loss of appetite
DNA mutations in normal cells cause ALL. However, the exact causes of these mutations are not known. The propensity to get an ALL attack may increase due to the following factors:
Exposure to ionising radiation and certain toxic chemicals like benzene
Genetic syndromes like Down’s Syndrome, Ataxia Telangiectasia, Bloom’s Syndrome and Fanconi’s Anaemia
An ALL-affected twin or sibling
A complete blood picture and blood film are often resorted for the diagnosis of ALL. The disease can also be diagnosed through a bone marrow test, where a sample of bone marrow is taken from the back of the pelvic bone. Additional tests like flow cytometry and cytogenetics can also be done on the same sample. The information thus generated provides clues to the right course of treatment. Lumbar puncture (spinal tap), that is, drawing a small amount of spinal fluid to test for the presence of cancer cells, may also be used for diagnosis. Chest x-rays and baseline blood tests to look at kidney and liver functions may also be required.
ALL is usually treated with chemotherapy. It involves administering a combination of drugs intravenously, orally and directly into the spinal fluid (intrathecal chemotherapy). Children require intensive treatment for five to six months, followed by maintenance chemotherapy for anywhere between 2 and 2.5 years. There are different chemotherapy regimens based on the clinical situation.