Acute lymphocytic leukaemia, also known as acute lymphoblastic leukaemia is a type of malignancy of the blood and bone marrow (the soft spongy connective tissue that is present within the bones and is a place where blood cells are synthesized). The term ‘acute’ in the name of the condition signifies a chronic, aggressive, type of blood cancer illustrated by the production of immature blood cells rather than mature healthy ones.

This type of cancer is widespread in children and with proper diagnosis and complete treatment, there is a significant chance to be cancer-free and reduce the chances of recurrence. But in the case of adults, the survival rate reduces as a complete cure from Acute lymphoblastic leukaemia is greatly diminished.
Acute lymphocytic leukemia

Causes

While the absolute cause of this type of blood cancer is still unknown, some studies entail that Acute lymphoblastic leukaemia may arise when there is a certain change or mutation in the DNA of the bone marrow cells. This sudden genomic alteration causes the bone marrow to synthesize immature lymphocytes that gradually change into leukemic white blood cells termed myeloblasts. These abnormal cells do not function like the normal ones, and they mainly grow irregularly in shape and size without perishing and agglomerating to form tumorous structures.

Risk Factors

Certain causative factors that make a person predisposed to Acute Lymphocytic Leukaemia include:

Age: Acute lymphocytic leukaemia is more commonly noticed in people belonging to the age group of 65 years or older

Gender: This type of blood cancer is more commonly detected in the male counterpart than in female

Chemicals: Getting exposed to certain harmful chemicals, like detergents, pesticides, benzene, or paint strippers, may make a person more prone to acute lymphocytic leukaemia

Radiation: Being in close proximity to high levels of radiation can increase the risk of ALL

Smoking: Addiction to tobacco in any form or continuous smoking can aggravate the chances of getting detected with Acute lymphocytic Leukemia

Blood Disorders: The risk of Acute lymphocytic leukaemia is more common in people suffering from other blood disorders in the past like polycythemia vera myelodysplasia, myelofibrosis, or thrombocythemia

Genetic Factors: Some genetic disorders, like Trisomy 8, Neurofibromatosis type 1, Down’s syndrome, or Li-Fraumeni syndrome increases the incidence of Acute lymphocytic leukaemia

Previous Cancer Therapy: People who've had a previous history of any cancerous condition or were subjected to certain types of cancer therapy like chemotherapy or radiation therapy are at an aggravated risk of developing Acute lymphocytic leukaemia

Symptoms

Although the initial indications of Acute Lymphocytic Leukaemia might mimic that of a common cold or flu, the common characteristic manifestations of Acute Lymphocytic Leukaemia include:

  • Bone pain
  • Getting bruised frequently
  • Bleeding from the gums
  • Swollen and inflamed gums
  • Sudden fever
  • Recurrent infections
  • Swollen and inflamed liver and spleen
  • Sudden weight loss
  • Loss of appetite
  • The appearance of small red dots on the skin
  • Frequent nosebleeds
  • Intense headaches
  • Trouble in breathing
  • Pale skin
  • General debility
  • Fatigue

Diagnosis And Treatment

On noticing the above-mentioned signs and symptoms, do consult an oncologist at the earliest without further delay. The doctor usually does a thorough physical check-up, acknowledges the patient's past and family medical history and conducts the following diagnostics:

  • A complete blood count for analysing the different blood cells
  • Bone Marrow Test
  • Imaging tests like X-rays, CT-scan, MRI-scan and Ultrasounds
  • Lumbar Puncture/ spinal tap (testing cerebrospinal fluid)
  • Genomic Testing

Treatment

Acute Lymphocytic Leukaemia is quite an aggressive form of cancer and needs immediate medical intervention. Once the presence of malignant cells gets confirmed, the treatment plan usually depends on the size, location and stage of the tumour and the condition of the patient. The treatment plan is usually divided into two phases:

Phase I:

  • Induction therapy
  • Consolidation therapy
  • Maintenance therapy
  • Preventive treatment of the spinal cord

Phase II

  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Drug therapy
  • Bone marrow transplant
  • Engineering immune cells to fight leukaemia
  • Clinical trials