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Acute Lymphocytic Leukemia: Causes, Symptoms, and Treatments

Acute lymphocytic leukemia (ALL) is the cancer of bone and bone marrow.  Bone marrow is the spongy connective tissue within the bones which produces the blood cells. In this type of cancer, the immature lymphocytes, (type of white blood cells) multiply at a faster rate when compared to the mature blood cells.

ALL is the most common childhood cancer with a significant number of cases reported in children below the age of five. Although, ALL is an aggressive form of blood cancer, the scope of treatment and cure is higher in children when compared to the adult population.

Acute Lymphocytic Leukemia

Symptoms

The common symptoms include:

  • Bone pain
  • Fatigue
  • Fever
  • Hepatomegaly (enlargement of the liver)
  • Joint pain
  • Lump formation due to swollen lymph nodes
  • Shortness of breath
  • Splenomegaly (enlargement of the spleen)
  • Testicular enlargement

Causes

Acute lymphocytic leukemia occurs due to mutation in gene of the blast cells (immature blood cells). This results in building up of immature blast cells and decreased normal blood cell count.

Risk Factor

The risk factors of acute lymphocytic leukemia include:

  • Exposure to Radiations: Frequent exposure to radiations such as x-ray or other scans and working in conditions with high exposure to radiations increases the risk of developing ALL.
  • Exposure to Chemicals: Frequent exposure to cytotoxic chemicals such as benzene, harmful hair dyes, glues, detergents, and certain chemotherapy drugs increase the risk of ALL.
  • Viral Infections: Viral infections are major risk factor for ALL. The infection of T-lymphocytes by T-cell leukemia virus-1 (HTLV-1) causes a rare type of T cell ALL. Other infections such as Epstein-Barr virus may cause a certain type of ALL or Burkitt’s lymphoma.
  • Inherited Syndromes: Certain inherited conditions may increase the risk of developing ALL, such as:
    • Down syndrome
    • Fanconi’s anemia
    • Bloom syndrome
    • Neurofibromatosis
    • Ataxia-telangiectasia
    • Klinefelter’s syndrome
    • Gender: Men are at a higher risk of developing ALL compared to women.
    • Other risk factors: Studies have shown the following factors to increase the risk of developing
    • Cigarette smoking
    • Frequent exposure to electromagnetic radiations
    • Frequent exposure to gasoline or diesel
    • Frequent exposure to pesticides

Diagnosis and Treatment

Interventions

  • Blood tests: The test is performed to check the cell counts of various blood components in the body. The presence of large number of immature blast cells is a sign of leukemia.
  • Bone marrow aspiration test: A sample of the bone marrow is drawn out by inserting a specialized needle either into the pelvic bone or the breast bone. The bone marrow cells are evaluated to check for any abnormality in the size and shape of the blast cells.
  • Image tests: Imaging scan such as x-ray scan, computed tomography (CT) scan and ultrasound scans are performed to check if cancer has affected the surrounding organs and tissues. With respect to ALL detection, image scan of the bone and spinal cord are performed to check the spread of infection.
  • Spinal tap test: A spinal tap or a lumbar puncture test is performed by collecting the fluid surrounding the spinal cord (cerebrospinal fluid). The test is performed to check whether cancer has spread to the cerebrospinal fluid.

Treatment

The treatment for acute lymphocytic leukemia can be divided into different phases:

  • Induction Phase: It is the initial stage of cancer treatment that requires hospitalization. During this phase, large number of immature blast cells are destroyed, which helps in restoration of normal blood cells.
  • Consolidation Therapy: It is also called as post-remission therapy. The consolidation therapy focuses on destroying the remaining cancer cells present in the brain and the spinal cord.
  • Maintenance Therapy: This is also called as the third phase of the cancer treatment. The treatment focuses on preventing the regeneration of tumor cells. Cytotoxic drugs are usually administered in low doses during maintenance therapy, and the treatment may last for few months or a year or two.

The treatment for acute lymphocytic leukemia includes:

  • Chemotherapy: Cytotoxic drugs are administered to destroy the cancerous cells. Chemotherapy is a basic part of induction therapy but is also used for consolidation and maintenance therapies.
  • Radiation therapy: High-intensity radiations are used to destroy the cancer cells. Radiation therapy is usually considered when the cancer has spread to the brain and spinal cord.
  • Bone marrow transplant: A bone marrow transplant or stem cell transplant is performed during the consolidation therapy. The procedure replaces the affected bone marrow cells and promotes regeneration of normal blood cells. This treatment method is opted for patients with a high risk of remission.

Prevention

There are no proven causes of acute lymphocytic leukemia. But avoiding certain risk factors such as frequent exposure to harmful radiations and chemicals, and timely treatment of viral infections help in preventing the occurrence of acute lymphocytic leukemia.

Most individuals attain the remission stage after ALL treatment. However, some patients have relapse of ALL. Thus, post-induction therapy is necessary to prevent the relapse of the condition.

A regular exercise and certain lifestyle changes helps to improve overall health for long-term after treatment. Regular exercise also reduces emotional stress and lowers the risk of relapse of cancer.

Diet

The following are the measures to be followed while being treated for acute lymphocytic leukemia:

  • Eat foods that are less in fats and salt
  • Cut down alcohol intake
  • Ensure to eat at least 5 portions of fresh fruits and vegetables every day

FAQs

1. Can a previous cancer treatment increase the risk of acute lymphocytic leukemia (ALL)?

Yes. Individuals exposed to chemotherapy or radiation therapy in the past are likely to be at risk of developing ALL.

2. Am I at a risk of developing acute lymphocytic leukemia (ALL) if I have a sibling with the condition?

Yes. Having a sibling or a twin with ALL can increase your chances of developing acute lymphocytic leukemia.

3. Are there any alternative treatment methods for ALL?

No. There are no alternative treatment options for ALL. However, certain alternative therapies, such as acupuncture, massage, aromatherapy, and relaxation exercises can ease the side effects resulting from cancer treatment.

4. Are there any special precautions while being treated for ALL?

Yes. Individuals who are being treated for ALL should avoid being in crowds and close contact with people who are suffering from contagious illnesses, such as measles, flu, and chicken pox.

5. Does chemotherapy result in any side effects?

Yes. Depending on the type of drugs used and doses, chemotherapy can cause side effects, such as hair loss, damage to the bones, easy bruising, and increased risk of developing infection.

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