Childhood Acute Lymphocytic Leukemia (ALL) | I D Cancer Center
Comprehensive Diagnosis & Advanced Treatment for Children at I D Cancer Center, Lucknow
Childhood Acute Lymphocytic Leukemia (ALL) is the most common type of cancer in children, accounting for nearly 25–30% of all childhood cancers. It begins in the bone marrow, where immature white blood cells called lymphoblastsgrow uncontrollably and crowd out normal blood-forming cells.
Childhood Acute Lymphocytic Leukemia (ALL) is the most common type of cancer in children, accounting for nearly 25–30% of all childhood cancers. It begins in the bone marrow, where immature white blood cells called lymphoblastsgrow uncontrollably and crowd out normal blood-forming cells.
What Is Childhood ALL?
In ALL, the bone marrow produces too many abnormal lymphoblasts (either B-cell or T-cell type). These cells do not function normally and spread quickly to the blood, lymph nodes, liver, spleen, or the central nervous system.
The good news: Childhood ALL is one of the most treatable cancers, with cure rates exceeding 85–90% when detected early and treated appropriately.
In ALL, the bone marrow produces too many abnormal lymphoblasts (either B-cell or T-cell type). These cells do not function normally and spread quickly to the blood, lymph nodes, liver, spleen, or the central nervous system.
The good news: Childhood ALL is one of the most treatable cancers, with cure rates exceeding 85–90% when detected early and treated appropriately.
Common Symptoms of Childhood ALL
Symptoms may develop gradually over weeks and can resemble common infections.
Persistent fever or frequent infections
Fatigue, weakness, or paleness
Easy bruising or bleeding
Bone or joint pain
Swollen lymph nodes
Abdominal swelling (enlarged liver/spleen)
Loss of appetite or weight loss
Headache, vomiting (if CNS involvement)
Any child with persistent or multiple symptoms should be evaluated promptly.
Symptoms may develop gradually over weeks and can resemble common infections.
Persistent fever or frequent infections
Fatigue, weakness, or paleness
Easy bruising or bleeding
Bone or joint pain
Swollen lymph nodes
Abdominal swelling (enlarged liver/spleen)
Loss of appetite or weight loss
Headache, vomiting (if CNS involvement)
Any child with persistent or multiple symptoms should be evaluated promptly.
Risk Factors
Although the exact cause is unknown, certain factors increase risk:
Genetic predisposition (Down syndrome, Li-Fraumeni, etc.)
Family history of leukemia
Previous radiation exposure
Certain viral infections
Immune system weakness
Most children develop ALL without any clear risk factor, so early evaluation is important.
Although the exact cause is unknown, certain factors increase risk:
Genetic predisposition (Down syndrome, Li-Fraumeni, etc.)
Family history of leukemia
Previous radiation exposure
Certain viral infections
Immune system weakness
Most children develop ALL without any clear risk factor, so early evaluation is important.
How Childhood ALL Is Diagnosed
Evaluation at I D Cancer Center follows an internationally recognised protocol:
Evaluation at I D Cancer Center follows an internationally recognised protocol:
1. Blood Tests
Complete blood count (CBC)
Peripheral smear
Liver, kidney function tests
Complete blood count (CBC)
Peripheral smear
Liver, kidney function tests
2. Bone Marrow Examination
Bone marrow aspiration & biopsy
Identifies blast percentage and cell type
Bone marrow aspiration & biopsy
Identifies blast percentage and cell type
3. Flow Cytometry
Determines whether leukemia is B-cell or T-cell type.
Determines whether leukemia is B-cell or T-cell type.
4. Cytogenetics & Molecular Testing
Chromosome studies (e.g., Philadelphia chromosome)
Mutation analysis
- Minimal residual disease (MRD) trackingThese guide treatment intensity and prognosis.
Chromosome studies (e.g., Philadelphia chromosome)
Mutation analysis
5. Imaging
Chest X-ray
Ultrasound abdomen
MRI/CT if CNS involvement suspected
Chest X-ray
Ultrasound abdomen
MRI/CT if CNS involvement suspected
6. Lumbar Puncture (CSF Study)
To check for spread to the central nervous system.
To check for spread to the central nervous system.
Treatment Options at I D Cancer Center
Childhood ALL requires phased, structured treatment lasting 2–3 years. We follow international evidence-based guidelines.
Childhood ALL requires phased, structured treatment lasting 2–3 years. We follow international evidence-based guidelines.
1. Induction Therapy
2. Consolidation / Intensification
Destroys remaining cancer cells and prevents relapse.
Destroys remaining cancer cells and prevents relapse.
3. Maintenance Therapy
Long-term (up to 2 years) low-dose medicines to maintain remission.
Long-term (up to 2 years) low-dose medicines to maintain remission.
4. CNS-Directed Therapy
Leukemia often hides in the CNS; treatment may include:
Intrathecal chemotherapy
Systemic chemo that crosses blood-brain barrier
Targeted radiotherapy in selected cases
Leukemia often hides in the CNS; treatment may include:
Intrathecal chemotherapy
Systemic chemo that crosses blood-brain barrier
Targeted radiotherapy in selected cases
5. Targeted Therapy
For genetically defined subtypes:
Tyrosine kinase inhibitors (e.g., in Philadelphia+ ALL)
For genetically defined subtypes:
Tyrosine kinase inhibitors (e.g., in Philadelphia+ ALL)
6. Immunotherapy (Advanced & Relapse Settings)
CAR-T cell therapy
- Monoclonal antibodiesProvides new hope for difficult-to-treat cases.
CAR-T cell therapy
7. Bone Marrow Transplant (Selected High-Risk Cases)
In collaboration with partnering super-specialty centers.
In collaboration with partnering super-specialty centers.
8. Supportive Care
We prioritise child comfort and safety:
Infection control
Nutrition and hydration
Blood transfusions
Pain and symptom management
Psychological support for child and family
We prioritise child comfort and safety:
Infection control
Nutrition and hydration
Blood transfusions
Pain and symptom management
Psychological support for child and family
Prognosis
Outcomes for childhood ALL are excellent with modern therapy.
Key factors influencing prognosis:
Age at diagnosis
Initial white blood cell count
Response to initial treatment
Genetic mutations
MRD status
Most children who achieve early remission and adhere to treatment have a very high chance of long-term cure.
Outcomes for childhood ALL are excellent with modern therapy.
Key factors influencing prognosis:
Age at diagnosis
Initial white blood cell count
Response to initial treatment
Genetic mutations
MRD status
Most children who achieve early remission and adhere to treatment have a very high chance of long-term cure.
