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A.L.L
Acute lymphocytic leukemia
Also Called: Acute Childhood Leukemia
ALL "is a progressive, malignant disease characterized by large numbers of immature white blood cells that resemble lymphoblasts. These cells can be found in the blood, the bone marrow, the lymph nodes, the spleen, and other organs." I don't know what lymphoblasts are???
ALL is responsible for 80% of the acute leukemias of childhood, usually occurring between ages 3 and 7. ALL can also occur in adults, where it comprises 20% of all adult leukemias. In acute leukemia, the malignant cell loses its ability to mature and specialize its function. These cells multiply rapidly and replace the normal cells. Bone marrow failure occurs as malignant cells replace normal bone marrow elements. The person becomes susceptible to bleeding and infection because the normal blood cells are reduced in number.
Most cases don't seem to have a cause. However, radiation, some toxins such as benzene, and some chemotherapy agents are thought to contribute to the induction of leukemia. Abnormalities in chromosomes may also play a role in the development of acute leukemia. Risk factors for acute leukemia include Down syndrome, a sibling with leukemia, and exposure to radiation, chemicals, and drugs. Acute Leukemia occurs in every 6 out of 100,000 people.
Symptoms
prolonged or excessive bleeding, bruising easily, bleeding gums, nosebleeds, bleeding into the skin, abnormal menstrual periods, skin rash or lesion, pinpoint red spots (petechiae), bruises (ecchymoses), paleness, fatigue, infection, sternal tenderness, bone pain or tenderness (breastbone (sternum)), joint pain, hip pain, knee pain, ankle pain, foot pain (over small joints of the foot ), shoulder pain, elbow pain, wrist pain, hand pain (over small joints of the hand), lymphadenopathy (enlarged glands), unintentional weight loss, fever, swollen gums, shortness of breath (aggravated by exercise), sensations of feeling the heart beat (palpitations) with an irregular pattern
Treatment
The goal of treatment is remission of the cancer. A remission is achieved when the peripheral blood counts and the bone marrow are normal.
ALL is treated with a combination of chemotherapy drugs. A hospitalization of three to six weeks may be necessary for the first chemotherapy treatment, however, subsequent chemotherapy sessions may be administered on an outpatient basis. An isolation procedures may be necessary if the lymphocyte count is very low to prevent exposure to infectious agents.
Chemotherapy usually consists of a combination of 3 to 8 different medications which may include: prednisone, vincristine, methotrexate, 6-mercaptopurine, and cyclophosphamide. It may also be necessary to administer blood products (e.g., packed red blood cells, platelets) to correct the anemia and low platelet count. Antibiotic therapy may be required to treat any secondary infections that develop.
After remission is achieved, chemotherapy and/or radiation therapy is administered in the spinal column to treat any leukemic cells that may have invaded the spinal fluid.
Subsequent therapy is directed at preventing relapse. A bone marrow transplant after high-dose chemotherapy is a treatment option for cases that relapse or do not respond to other treatments. The usual cost of a bone marrow transplant ranges from $150,000 to $200,000.
Prognosis
The probable outcome for children is better than for adults, with approximately 95% achieving complete remission and a cure rate of 50% to 60%. Eighty percent of adults achieve complete remission, with 30% to 50% being cured. Without treatment, the life expectancy is about 3 months.
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