Adult Acute Lymphoblastic Leukemia

Adult Acute Lymphoblastic Leukemia at a Glance

• White males older than 70 are at risk for Adult Acute Lympohblastic Leukemia.
• Other risk factors include past treatment with chemotherapy or radiation therapy, exposure to atomic bomb radiation or having a certain genetic disorder such as Down syndrome.
• The early signs of ALL may be similar to the flu or other common diseases.
• Consult a doctor if any of the following problems occur: weakness or feeling tired, fever, easy bruising or bleeding, petechiae (flat, pinpoint spots under the skin caused by bleeding), shortness of breath, weight loss or loss of appetite, pain in the bones or stomach, pain or feeling of fullness below the ribs, painless lumps in the neck, underarm, stomach, or groin.
• New aggressive therapies have increase survival rates.

What Is Adult Acute Lymphoblastic Leukemia?

Leukemia is a form of cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream. Adult acute lymphoblastic leukemia (ALL) is a type of leukemia in which the bone marrow makes too many lymphocytes. This type of cancer usually gets worse quickly if it is not treated.

According to an estimate, 5,330 new cases may be diagnosed and 1,420 deaths may happen from ALL in the United States in 2010. Sixty percent to 80% of adults with ALL can be expected to attain complete remission status following appropriate induction therapy. Approximately 35% to 40% of adults with ALL can be expected to survive 2 years with aggressive induction combination chemotherapy and effective supportive care during induction therapy.

Normally, the bone marrow makes blood stem cells (immature cells) that develop into mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell.

The myeloid stem cell develops into one of three types of mature blood cells:

• Red blood cells that carry oxygen and other materials to all tissues of the body.
• Platelets that help prevent bleeding by causing blood clots to form.
• Granulocytes (white blood cells) that fight infection and disease.

The lymphoid stem cell develops into a lymphoblast cell and then into one of three types of lymphocytes:

• B lymphocytes that make antibodies to help fight infection.
• T lymphocytes that help B lymphocytes make the antibodies that help fight infection.
• Natural killer cells that attack cancer cells and viruses.

About Leukemic Cells

In ALL, too many stem cells develop into lymphoblasts or lymphocytes. These cells may also be called leukemic cells. These leukemic cells are not able to fight infection very well. Also, as the number of leukemic cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. The cancer can also spread to the central nervous system (brain and spinal cord).

Risk Factors

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor.

Possible risk factors for ALL include the following:

• Being male.
• Being white.
• Being older than 70.
• Past treatment with chemotherapy or radiation therapy.
• Exposure to atomic bomb radiation.
• Having a certain genetic disorder such as Down syndrome.

Signs and Symptoms

The early signs of ALL may be similar to the flu or other common diseases. A doctor should be consulted if any of the following problems occur:

• Weakness or feeling tired.
• Fever.
• Easy bruising or bleeding.
• Petechiae (flat, pinpoint spots under the skin caused by bleeding).
• Shortness of breath.
• Weight loss or loss of appetite.
• Pain in the bones or stomach.
• Pain or feeling of fullness below the ribs.
• Painless lumps in the neck, underarm, stomach, or groin.