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Acute lymphoblastic leukaemia: Treatment, symptoms, advice and help

About acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia is a rapidly progressive cancerous condition of the blood characterised by increased production of a large number of abnormal blood cells. These abnormal blood cells are immature white blood cells called ‘blast’ cells.

Acute lymphoblastic leukaemia: Incidence, age and sex

Acute lymphoblastic leukaemia can occur at any age, but it is more frequently seen in children than adults. There seems to be no definite gender bias. Children, especially under the age of 10 years are more susceptible to acquiring this kind of leukaemia.

Causes and prevention of acute lymphoblastic leukaemia

There are three kinds of blood cells namely red blood cells, white blood cells and platelets which are produced in the bone marrow, a part of the bone. Normally, these cells are released from the bone marrow into the blood stream where they carry out their functions. In acute lymphoblastic leukaemia, this normal production of white blood cells gets hampered. Enormous number of abnormal white blood cell, ‘blast’ cells are then produced in rapid progression and released into the blood stream. Not only do these immature cells not function properly but they crowd out the normal red blood cells and platelets, leading to typical clinical features.

Some factors which may cause acute lymphoblastic leukaemia are exposure to radiation, toxic materials like benzene, prenatal exposure to X-ray radiations and genetic factors. These factors are a result of hypothesis based on research studies and at present, no definite cause can be attributed to leukaemia.

Signs and symptoms of acute lymphoblastic leukaemia: Diagnosis

The severity of clinical features depends upon the ratio of normal blood cells to ‘blast’ cells.

The patient may complain of anaemia, tiredness and loss of appetite which is due to the decrease in the number of red blood cells. Reduced platelets may cause an increased likelihood of bleeding from small cuts and from the nose and gums. Because of the low white blood cell count the body is unable to fight against infectious agents like bacteria and virus, thus increasing the chances of infection. Fever, sweating at night, bone pain and joint pain are some other clinical features. The physician on examination, may find an increase in size of the lymph nodes which is caused by the collection of abnormal blood cells. Physical examination may also show pallor or pin point red spots under the skin.

Acute lymphoblastic leukaemia: Complications

The complications of acute lymphoblastic leukaemia can be seen as profuse bleeding or severe infections which may result in prolonged hospitalisation or in rare instances, death. Moreover the abnormal blood cells may spread to the brain, which signifies a poor prognosis. Complications may also arise during the treatment of acute leukaemia, such as damage of organs due to chemotherapy.

Acute lymphoblastic leukaemia: Treatment

The diagnosis can be confirmed by some blood tests and lumbar puncture. Lumbar puncture is used to aspirate bone marrow and see whether the cancer has spread to spinal cord and brain. The treatment of acute lymphoblastic leukaemia depends on the age and health status of the patient.

The treatment modalities include chemotherapy which helps in killing the abnormal cells. Radiotherapy is indicated when the malignancy has spread to brain and spinal cord. Regular blood transfusions may be needed to prevent anaemia and bleeding. Concurrently, occurring infections need to be treated with appropriate medication. The best available treatment for acute lymphoblastic leukaemia is replacing the affected bone marrow with a healthy one. Since it is a surgical procedure, it carries some risk. Stem cell transplant, the latest advancement, may also be considered.

Acute lymphoblastic leukaemia has a good prognosis and survival rate, especially in children. Most of the children diagnosed with this type of leukaemia go into complete remission with treatment.