Acute lymphocytic leukemia
Key points
- Acute lymphocytic leukemia is a progressive, malignant disease characterized by large numbers of immature white blood cells that resemble lymphoblasts.
- Acute lymphocytic leukemia (ALL) is responsible for 80% of the acute leukemias of childhood, with the peak incidence occurring between ages 3 and 7.
- Signs and tests Physical examination shows enlarged liver and spleen, bruising (ecchymosis) and evidence of bleeding (petechiae, purpura, and so on).
- A remission is achieved when the peripheral blood counts and the bone marrow are normal.
Alternative names
ALL; Acute childhood leukemia; Cancer - acute childhood leukemia (ALL)
Definition
Acute lymphocytic leukemia 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.
Causes, incidence, and risk factors
Acute lymphocytic leukemia (ALL) is responsible for 80% of the acute leukemias of childhood, with the peak incidence occurring between ages 3 and 7. ALL also occurs in adults, where it comprises 20% of all adult leukemias.
In acute leukemia, the malignant cell loses its ability to mature and specialize (differentiate) 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 seem to have no apparent 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. The incidence is 6 out of 100,000 people.
Symptoms
- Prolonged or excessive bleeding, bruising easily
- Bleeding gums
- Nosebleeds
- Bleeding into the skin
- Menstrual periods, abnormal
- Skin rash or lesion
o Pinpoint red spots (petechiae)
o Bruises (ecchymoses) - Paleness
- Fatigue
- Infection
- Sternal tenderness
- Bone pain or tenderness
o Breastbone (sternum) - Joint pain
o Hip pain
o Knee pain
o Ankle pain
o Foot pain over small joints of the foot
o Shoulder pain
o Elbow pain
o Wrist pain
o Hand pain over small joints of the hand - Lymphadenopathy (enlarged glands)
- Unintentional weight loss
- Fever
Written and revised by
Andrey Nailor, M.D.
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