Medical Conditions

Acute Lymphocytic Leukemia (ALL) Facts

• The most common type of leukemia in children under age 15.

• The risk of getting ALL increases in people ages 45 and older.
• Higher rates of ALL occur in developed countries.
• Females tend to have a better prognosis.
• Children between 1-10 years of age have the highest chance of being cured.
• Survival rate for ALL is 66.3 percent overall; 90.9 percent for children under 5.

Prognosis for ALL
Forty years ago the survival rate for patients diagnosed with ALL was zero. Today the survival rates are much higher ranging from 20% to 75%. Clinical trials have contributed to the improved prognosis.

The current 5-year survival rates evaluate older treatments — new drugs and genetic testing to match treatment with genetic characteristics of the blast cells have shown to dramatially improve survival rates. Age and other factors also play a role in the prognosis for patients diagnosed with Acute Lymphocytic Leukemia (ALL). Recent studies indicate that the clinical outcome in childhood ALL can be predicted with accuracy by MRD testing at intervals following diagnosis.

ALL Current Survival Statistics
Survival statistics for ALL are largely based on data that does not include current treatment options. Improved outcomes from new drug combinations and agents, better supportive care and clinical trials are dramatically changing the survival statistics for patients diagnosed with ALL. If you have been diagnosed with ALL make sure to ask your doctor whether molecular diagnostic testing and newer tailored treatments may be options for you.

What to expect when you get diagnosed with ALL
Leukemia may be suspected by your doctor if you have an abnormal complete blood count (CBC). Your doctor will conduct a series of diagnostic tests to rule out other blood disorders and medical problems. A number of blood tests are performed. These tests are used to evaluate the type and quantity of blood cells that are present, the blood chemistry, and other factors. Your doctor will most likely request a bone marrow biopsy.

In a bone marrow biopsy a sample of bone marrow is taken from the hip bone or another large bone. A bone marrow biopsy measures the blast count. While blast cells are seen on blood smear in 90% of cases a bone marrow biopsy is the only sure way to determine whether leukemia cells are in the bone marrow. Doctors in the lab perform tests and look for changes in the cancer cells. Doctors classify your blood cells into particular types and also determine if the leukemia cells began from B or T lymphocytes.

Additional testing including DNA testing can determine the aggressiveness of your ALL; prognostic factors are determined by certain mutations. This testing is conducted so that your doctor can determine the best possible treatment options for you based on risk factors and other indicators.

Treatment for ALL
ALL is a rapidly progressing blood cancer. Usually the doctor will want to being treatment immediately.The doctor will consider the results of the laboratory tests and the patient's risk factors such as disease traits and other genetic factors when determining the best treatment for the patient. A combination therapy that includes chemotherapy is usually the treatment of choice for most ALL patients. For some patients ALL cells may be resistant to chemotherapy and clinical trials may be an option. If you or a loved one have been diagnosed with ALL, ask the doctor about targeted treatment options.

What are symptoms of ALL?
Symptoms of ALL include many symptoms that are common with other ailments including fatigue, anemia, weight loss and joint pain to name a few. Since these symptoms are not specific to ALL doctors will perform tests to determine the cause of the symptoms. 

Questions to ask your doctor

• How do I choose a blood cancer specialist?
• Do I need more tests to confirm the diagnosis?
• What is the approach to treatment?
• What new treatments are currently being developed and studied in clinical trials?
• Should I get a second opinion about my diagnosis and/or my treatment?

Alternate Names for ALL
Acute lymphocytic leukemia is also called:
Acute lymphoblastic leukemia
Acute lymphoid leukemia