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Acute lymphocytic leukemia (ALL)


Acute lymphocytic leukemia (ALL) is a fast-growing cancer in which the body produces a large number of immature white blood cells (lymphocytes). These cells are found in the blood, bone marrow, lymph nodes, spleen, and other organs.


ALL makes up 80% of childhood acute leukemias. Most cases occur in children ages 3 - 7. The disease may also occur in adults.

In acute leukemia, cancerous cells multiply quickly and replace normal cells. Cancerous cells take over normal parts of the bone marrow, causing bone marrow failure. A person with ALL is more likely to bleed and have infections because there are fewer normal blood cells.

Most cases of ALL have no obvious cause. However, the following may play a role in the development of leukemia:

  • Chromosome problems
  • Radiation
  • Some chemotherapy drugs
  • Toxins such as benzene

Persons with Down syndrome or who have a brother or sister with leukemia are at increased risk for ALL.


  • Bleeding gums
  • Bone pain or tenderness
  • Easy bruising
  • Excessive or prolonged bleeding
  • Fatigue
  • Fever
  • Joint pain
  • Infection
  • Menstrual irregularities
  • Nosebleeds
  • Paleness
  • Palpitations
  • Pinpoint red spots on the skin (petechiae)
  • Shortness of breath (made worse by exercise)
  • Swollen glands (lymphadenopathy)
  • Swollen gums
  • Unintentional weight loss


The goal of treatment is to get the blood counts and the bone marrow back to normal. If this occurs, the cancer is said to be in remission.

If you have ALL, you will need chemotherapy. For the first round of chemotherapy, you may need to go to the hospital for 3 - 6 weeks. Later you may get chemotherapy on an outpatient basis. If you have a low white blood cell count, you may need to be placed in a room by yourself so you do not catch an infection.

Additional treatments depend on other symptoms. They may include:

  • Transfusion of blood products, such as platelets or red blood cells, to fight thrombocytopenia and anemia
  • Antibiotics to fight infection, especially if a fever occurs

If you go into remission, you may receive additional chemotherapy or radiation therapy to kill any cancer cells that are in the spinal fluid. You may also receive chemotherapy from time to time to prevent relapse. A bone marrow or stem cell transplant may also be recommended, especially if one of your siblings is proven to be a full match.

If your leukemia returns or does not respond to other treatments, a bone marrow or stem cell transplant is usually recommended.


Children usually have a better outcome than adults. Most adults go into complete remission. Without treatment, a person with ALL can expect to live for only about 3 months.


Because the cause is usually unknown, it is not possible to prevent most cases. You may reduce your risk of ALL by avoiding exposure to toxins, radiation, and chemicals.