Acute lymphocytic leukemia (ALL)

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	Acute lymphocytic leukemia - photomicrograph	Auer rods	Bone marrow aspiration
Bone marrow from hip

ALL; Acute childhood leukemia; Cancer - acute childhood leukemia (ALL); Leukemia - acute childhood (ALL)

The goal of treatment is to get the blood counts back to normal. If this occurs and the bone marrow looks healthy under the microscope, the cancer is said to be in remission.

Chemotherapy is used to treat this type of leukemia.

• The first time you receive chemotherapy, you may need to stay in the hospital for several weeks.
• Later you may receive chemotherapy as an outpatient, meaning you come to a clinic to receive the treatment

If you have a low white blood cell count, you may need to be placed in a hospital room by yourself so you do not catch an infection.

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ALL may spread to the brain and spinal cord. Chemotherapy drugs givent through a vein cannot reach these areas. Therefore, you may also receive:

• Chemotherapy given directly into the space around your brain or in the spinal column
• Radiation therapy to the brain

You may also receive chemotherapy from time to time to prevent the cancer from coming back.

If your leukemia returns or does not respond to other treatments, a bone marrow or stem cell transplant is usually recommended. A bone marrow or stem cell transplant may also be recommended if you have a brother or sister who is a complete match, or if you have a high-risk type of leukemia.

Additional treatments depend on other symptoms. They may include:

• Transfusion of blood products, such as platelets or red blood cells
• Antibiotics to fight infection, especially if a fever occurs

Joining a support group where members share common experiences and problems may help ease the stress related to illness.

See: Cancer - support group

Most children with ALL can be cured. Children usually have a better outcome than adults.

The following patients tend to do better:

• Younger adults (especially those younger than age 50)
• Children between the ages of 1 and 9
• Those who have a white blood cell (WBC) count below 50,000 when first diagnosed
• Those who do not have a specific genetic change called Philadelphia chromosome-positive ALL
• Those whos are in remission within 4 - 5 weeks of starting treatment

Patients whose leukemia spreads to the brain or spinal cord tend to have a worse outcome.

• Bleeding
• Damage to different organs from chemotherapy
• Disseminated intravascular coagulation (DIC)
• Relapse of ALL
• Severe infection
• Spread of the cancer to other parts of the body

Call your health care provider if:

• You develop ALL-like symptoms
• You have ALL and you have a persistent fever or other signs of infection

Review Date: 02/28/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).