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Acute Lymphoblastic Leukemia

Overview

What is the Leukemia?

As the disease progresses, leukaemic blast cells get into the bloodstream and accumulate in various organs, namely lymph nodes, spleen, liver and central nervous system (brain and spinal cord). ALL is more prevalent among children than it is among adults.

What is Acute Lymphoblastic Leukemia?

Acute Lymphoblastic Leukaemia (ALL) or Acute Lymphocytic Leukaemia is a type of cancer that affects the blood and bone marrow, the spongy tissue inside bones where the blood cells are produced. Acute lymphoblastic leukaemia is caused by the overproduction of immature white blood cells called lymphoblast or leukaemic blasts.

Causes

While the exact causes of ALL are not known, this disease is believed to result from mutations in the genes that are responsible for blood cell development and growth.

Exposure to Radiation: Exposure to high doses of radiation either accidentally or therapeutically
Exposure to Harmful Chemicals: Exposure to industrial chemicals, namely benzene, pesticides, and certain chemo drugs used to treat other forms of cancers
Infections: Certain types of viral infections Specific Genetic

Disorders: Certain genetic disorders like Down syndrome and Fanconi anaemia increase the risk of developing ALL.
Poor Immunity: An overall weakened immune system may also increase the risk of ALL.

Diagnosis

Acute lymphoblastic leukaemia is usually diagnosed by examining blood and bone marrow samples.
  • Full Blood Count: The diagnosis of ALL begins with a Full Blood Count (FBC) or Complete Blood Count (CBC).
  • Bone Marrow Examination: A bone marrow biopsy is suggested in order to confirm the primary diagnosis.
  • Further Testing: Once ALL is confirmed, blood and bone marrow cells are examined further using special laboratory tests.

Chest x-rays and baseline blood tests could also be performed to study the kidney and liver functions.

Treatment

ALL is one such cancer that progresses quickly, and therefore, it has to be treated as soon as it is diagnosed. Multiple factors are to be considered before devising a treatment plan, and they include the subtype and stage of ALL, the patient’s age and the overall health. Following are the common methods used to treat ALL:
Chemotherapy
While treating ALL with chemotherapy, a combination of drugs, including steroids is administered in multiple cycles for a specific period of time. The primary goal of chemotherapy is to destroy all the leukaemic cells and induce remission.
  • Induction Therapy
  • Maintenance Therapy
Bone Marrow Transplantation
Bone marrow transplant is used as a treatment protocol for acute lymphoblastic leukaemia, especially if the risk of relapse is high. This procedure the faulty bone marrow cells with the healthy ones and thereby the production of normal blood cells is restored. Before the transplantation, high dose chemotherapy or radiation therapy is administered in order to destroy the marrow cells that are producing leukaemia cells. Later, the healthy marrow cells are transfused into the patient’s body.
Radiation Therapy
Although not standardised treatment, radiation therapy is recommended for ALL patients in the following conditions: To treat or manage the ALL that has spread to the brain or spinal cord To destroy the leukaemic cells completely before the bone marrow transplantation

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