Overview

Acute Lymphocytic Leukemia (ALL)—also called Acute Lymphoblastic Leukemia—is a fast-growing cancer of the bone marrow and blood, where immature white blood cells (lymphoblasts) multiply rapidly. ALL is the most common childhood cancer, but it can also occur in adults.

Timely diagnosis and structured treatment significantly improve survival.

At I D Cancer Center, we use advanced diagnostic techniques, modern chemotherapy protocols, targeted therapies, and supportive care to deliver the best possible outcomes.

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How ALL Develops

ALL begins when genetic changes in lymphoid cells cause uncontrolled growth. These abnormal blasts accumulate in:

• Bone marrow → leading to low red cells, white cells, and platelets

• Bloodstream

• Lymph nodes

• Liver and spleen

• In some cases, the brain and spinal cord

Early detection and immediate treatment are crucial.

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Common Symptoms

Symptoms of ALL develop quickly and include:

Blood & Bone Marrow Symptoms

• Severe fatigue

• Frequent infections

• Fever

• Easy bruising or bleeding

• Nosebleeds / gum bleeding

General Symptoms

• Loss of appetite

• Weight loss

• Night sweats

• Weakness

Lymphatic Symptoms

• Swollen lymph nodes (neck, armpits, groin)

• Enlarged liver or spleen

Neurological Symptoms (when CNS is involved)

• Headache

• Vomiting

• Blurred vision

• Difficulty walking

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Risk Factors

While most cases occur without a clear cause, certain factors increase risk:

• Childhood (common age 2–10 years)

• Older adults (>60 years)

• Previous chemotherapy or radiation

• Genetic disorders: Down syndrome, Fanconi anemia

• Exposure to radiation or toxic chemicals

• Family history (rarely)

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Diagnosis at I D Cancer Center

We provide complete hemato-oncology evaluation:

1. Blood Tests

• Complete blood count (CBC)

• Peripheral smear

• Serum markers

2. Bone Marrow Tests

• Bone marrow aspiration and biopsy

• Cell morphology

• Flow cytometry to classify type of ALL

• Cytogenetics & molecular testing (e.g., Philadelphia chromosome, BCR-ABL)

These tests define the risk category and guide treatment.

3. Imaging & CNS Evaluation

• Ultrasound

• Chest X-ray or CT

• Lumbar puncture to check for CNS involvement

Each case is discussed in our Multidisciplinary Tumor Board.

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Treatment Options

ALL treatment is systematic and divided into phases:

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1. Induction Therapy

Aim: Achieve complete remission by eliminating leukemia blasts.

Includes multi-drug chemotherapy.

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2. Consolidation / Intensification Therapy

Strengthens remission and targets hidden leukemia cells.

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3. Maintenance Therapy

Low-dose chemotherapy for 1–2 years

Prevents relapse and ensures long-term control.

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4. Targeted Therapy

Especially useful in Philadelphia-positive ALL (Ph+ ALL):

• Tyrosine kinase inhibitors (TKIs) such as Imatinib, Dasatinib
  These improve survival dramatically.

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5. Immunotherapy

Modern immune-based treatments:

• Blinatumomab (BiTE therapy)

• CAR-T cell therapy (available through referral centers)

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6. CNS-Directed Therapy

Leukemia can hide in the brain/spinal fluid.

CNS protection includes:

• Intrathecal chemotherapy

• CNS radiotherapy (rarely needed in children today)

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7. Stem Cell Transplant (SCT)

Recommended for:

• High-risk ALL

• Relapsed disease

• Ph+ ALL not responding fully to therapy

Offers a chance for long-term cure.

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Supportive Care

ALL patients need careful monitoring:

• Infection prevention

• Blood and platelet transfusions

• Nutrition support

• Management of treatment side effects

• Psychological counselling

Our team ensures 24/7 supportive care for safe treatment.

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Prognosis

Prognosis depends on:

• Age

• Genetic markers

• White cell count at diagnosis

• Treatment response

With modern therapies:

• Childhood ALL survival is 80–90%

• Adult outcomes continue to improve with targeted treatments

Early diagnosis and adherence to full therapy are key.