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Acute lymphocytic leukemia - Causes, Symptoms, Diagnosis, and Treatment

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Acute lymphocytic leukemia - Causes, Symptoms, Diagnosis, and Treatment

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Acute lymphocytic leukemia is a cancerous condition of the blood. Read this article to know more about the causes, symptoms, diagnosis, and treatment

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Rajesh Gulati

Published At January 6, 2021
Reviewed AtApril 10, 2024

What Is Leukemia?

Leukemia is a condition in which there is excessive proliferation of the cells like white blood cells. The white blood cells might include monocytes, lymphocytes, neutrophils, eosinophils, and basophils. When there is an increase in the number of cells more than the normal level, then it might result in a condition called leukemia. In simple terms, leukemia is known as blood cancer.

What Is Acute Lymphocytic Leukemia?

Acute lymphocytic leukemia is a condition in which there is a sudden spreading of the condition. It is also called acute lymphoblastic leukemia. The white cells also fail to achieve maturity, and these immature cells increase in number. It is a life-threatening condition. This condition can affect both adults and young children. Children are more commonly affected than older people. In children, the treatment is known to be very beneficial.

What Are the Causes of Acute Lymphocytic Leukemia?

The exact cause of acute lymphocytic leukemia is not known. The genetic mutations have caused acute lymphocytic leukemia in some people. Hereditary reasons are also the causative factor for acute lymphocytic leukemia.

What Are the Symptoms of Acute Lymphocytic Leukemia?

The symptoms experienced by patients with acute lymphocytic leukemia are:

  • Epistasis- In epistasis, a person has frequent bleeding of the nose. In some cases, the bleeding might be severe.

  • Lymphadenopathy- It is a condition in which some lumps are caused by swollen lymph nodes. It is seen in the neck, abdomen, groin, and armpits.

  • Pale skin.

  • Bone pain.

  • Bleeding of the gums.

  • The tendency to get infections quickly.

  • Shortness of breath.

  • Decreased energy levels in the body.

  • Weakness and fatigue.

  • Fever.

  • Testicular enlargement.

  • Cranial nerve palsy.

  • Enlargement of the spleen.

  • Purpura.

What Are the Risk Factors Associated With Acute Lymphocytic Leukemia?

The following are the risk factors that are associated with acute lymphocytic leukemia.

  • Chemical Exposure: All the chemicals might be suitable for the skin and tissues of the individuals. The long term exposure to certain chemicals might be harmful to people. Such exposure to hazardous chemicals might increase the risk of cancer in some people. These kinds of hazards are higher in people who are working in chemical factories. Benzene is a chemical that causes the highest risk of harmful exposure. In addition to these chemicals, chemotherapy drugs are also responsible for the occurrence of acute lymphocytic leukemia. The most common problem experienced by people under chemotherapy agents is the occurrence of secondary cancers. In secondary cancer, there is a spread of cancer from the primary site to the other site.

  • Radiation Exposure: Similar to chemical exposure, people who are having radiation exposure are also affected by acute lymphocytic leukemia. Reports from the year 1994 studies suggest that the Japanese people who were affected by World War II had the risk of being affected by acute lymphocytic leukemia even after survival. The condition was known to occur after six years. People who are working in nuclear reactor stations also have the highest possibility of getting affected by radiation exposure. The fetus in the womb, which receives a higher degree of radiation, is known to invite a higher risk of acute lymphocytic leukemia.

  • Infections: Infections with viruses and bacteria are known to elevate cancer risks. It might include the following.

    1. Epstein-Barr virus (EBV) that might cause infectious mononucleosis.

    2. Burkitt’s lymphoma.

  • Inherited Disorders: The following inherited disorders have an increased risk of suffering from acute lymphocytic leukemia.

    1. Bloom syndrome.

    2. Klinefelter syndrome.

    3. Down’s syndrome.

    4. Fanconi anemia.

    5. Neurofibromatosis.

    6. Ataxia-telangiectasia.

  • Gender: Males have a higher risk of being affected by acute lymphocytic leukemia than females. No specific reason has been identified for this.

  • Race: Caucasians have an increased possibility of being affected by acute lymphocytic leukemia when compared to people belonging to other races.

When to Visit a Physician?

If individuals detect any persistent symptoms that concern them, schedule a consultation with a physician. Acute lymphocytic leukemia has many symptoms that are similar to the flu. However, flu symptoms gradually resolve. Schedule a visit with a physician if the signs and symptoms are not getting better.

How Is Acute Lymphocytic Leukemia Diagnosed?

The diagnosis of acute lymphocytic leukemia requires a proper medical history. In addition to this, the doctor will perform a clinical examination to identify the physical signs and symptoms. The most important diagnostic methods that are used for the detection of acute lymphocytic leukemia are:

  • Bone Marrow Aspiration: A reduced number of red blood cells and increased bone marrow growth are being identified with the bone marrow aspiration technique. In this method, bone marrow is taken from the pelvic bone.

  • Blood Tests: A routine blood examination is done for the patients to identify the number of RBC (red blood cells), WBC (white blood cells), and platelets. Patients who are affected by acute lymphocytic leukemia have a low level of platelet and hemoglobin. An elevated level of WBS is noted in the blood examination.

  • Imaging Techniques: A chest X-ray is taken to identify the widening of the mediastinum of the chest. The spreading of cancer to other parts of the brain, spinal cord, and other parts of the body can be detected using computed tomography (CT scan).

  • Spinal Fluid Test: This test is also called a lumbar puncture test. The spinal fluid is collected from the brain and spinal cord to identify the presence of cancer cells in these fluids.

What Are the Treatment Options for Acute Lymphocytic Leukemia?

The treatment plan is decided by the doctor after considering the health status of the individual. The most commonly employed treatment options are:

  • Chemotherapy: Chemotherapy drugs are prescribed for the patients to control the excessive growth of the white blood cells. These drugs are suitable for both younger and older patients.

  • Radiation Therapy: Radiation therapy is the best treatment of choice for patients whose central nervous system is being damaged.

  • Targeted Therapy: This therapy focuses on the specific abnormality present in the body. It can be used alone or in combination with chemotherapy treatment based on the health of the individual.

  • Bone Marrow Transplant: In a bone marrow transplant, the bone marrow of the patient is replaced with a healthy and compatible donor.

  • Alternative Medicine: Alternative medicine does not provide a complete cure for acute lymphocytic leukemia, but it can be used to overcome the symptoms and effects caused by acute lymphocytic leukemia.

    • Exercise.

    • Acupuncture.

    • Relaxation activities.

    • Meditation.

    • Massage.

How Is the Treatment for Elderly People Planned?

Older individuals, specifically above 65, are more likely to encounter treatment-related problems. Furthermore, the prognosis for older adults receiving treatment for acute lymphocytic leukemia is often worse than that of children. Individuals may choose to receive therapy for their leukemia based on their medical history, their objectives, and their personal preferences. Some may decide not to pursue cancer therapy, preferring to concentrate on measures that alleviate their discomfort and allow them to maximize the time that remains.

What Are the Factors That Help to Determine the Prognosis?

The healthcare provider makes conclusions about the course of treatment and prognosis based on the data received from these tests and treatments. Acute lymphocytic leukemia lacks phases; other cancer types utilize numerical stages to represent the extent of their spread.

Rather, the following factors define how severe the illness is:

  • Which lymphocyte type—B cells or T cells—is at play

  • The particular genetic alterations in the cells of leukemia

  • Individual's age

  • Lab test results, such as the quantity of white blood cells found in a sample of blood


Acute lymphoblastic leukemia (ALL) is an uncommon blood malignancy. Though it's more frequent in younger kids than in teens and adults, anyone can develop ALL. Acute lymphocytic leukemia may return even after treatment. It is critical to address additional concerns related to a young kid's cancer treatment, such as offering the kid, their parents, and family emotional assistance.

Frequently Asked Questions


How Are Lymphocytic Leukemia and Lymphoblastic Lymphoma Different?

In the case of lymphocytic leukemia, cancer cells are located in the blood and bone marrow. In contrast, in lymphoblastic lymphoma, the tumor cells are present in the lymph nodes.


Can We Cure Acute Lymphocytic Leukemia?

Acute lymphocytic leukemia has a recovery rate of 40%. Although it is completely cured in about 80 to 90% of individuals, relapse is common in more than half of these individuals. In addition, the rate of prognosis is highly dependent on several factors like age, type of lymphocytic leukemia, response to chemotherapy, genetic abnormalities, and the general health of the individual.


What Happens When Leukemia Reaches the Final Stage?

- Slow breathing with extended pauses.
- Reduced urine output.
- Dry mouth.
- Bladder and bowel incontinence.
- Hallucinations.
- Cold skin.
- Restlessness along with involuntary movements.
- Less sensitive to touch and voice.


What Are the Risk Factors of Acute Lymphocytic Leukemia?

- Viral infections like the Epstein-Barr virus and human T-cell lymphoma/leukemia virus.
- Exposure to chemicals and radiation.
- Genetic syndromes like Down syndrome, Bloom syndrome, Klinefelter syndrome, neurofibromatosis, Fanconi anemia, etc.
- Children and adults above the age of 50.
- Having a twin with a history of acute lymphocytic leukemia.


What Are the Complications of Untreated Acute Lymphocytic Leukemia?

Leukemic cells outweigh the normal blood cells and build up in the bone marrow and blood, which fight against infections, thereby increasing the risk of developing anemia, recurrent infections, and excessive bleeding.


How Do Leukemia Spots Present Like?

Infiltration of the leukemic cells into the skin results in red and purplish-red bumps, affecting both the outer and inner skin and the tissue layer beneath the skin. It comprises flushed skin, scaly lesions, and plaques.


How Is Leukemia Pain Manifested?

Sharp or constant dull pain is present in leukemia due to the collection of abnormal leukemic cells in the bone marrow. Swelling may be associated with leukemic joint pain. Pain is more common in the long bones of the legs and arms.


How Is Acute Lymphocytic Leukemia Best Treated?

Chemotherapy is the best choice of treatment in acute lymphocytic leukemia, which involves three phases, namely, induction, consolidation, and maintenance. It usually takes two years. Vincristine, Dexamethasone, or Doxorubicin are the drugs used in the induction phases. It is mainly aimed at remission, which is destroying the cancer cells to attain an average count of bone marrow cells. The second phase involves taking the same drugs for a few months in high doses. At the last stage, Methotrexate and 6-Mercaptopurine are given for maintenance chemotherapy.


In Which Areas Do Leukemia Rashes Develop?

Leukemic rashes most commonly occur on the extremities like the arms and legs, buttocks, and stomach but can also occur in the eyelids and the inside of the mouth.


How Is Acute Lymphocytic Leukemia Diagnosed?

Tests used in the diagnosis of acute lymphocytic leukemia are:
1. Blood tests:
Complete blood count.
Peripheral blood smear.
Blood chemistry tests.
Coagulation tests.
2. Bone marrow tests:
Bone marrow aspiration and biopsy.
3. Laboratory tests:
Microscopic examination of the blood sample.
Flow cytometry.
4. Chromosome tests:
Fluorescent in-situ hybridization.
Polymerase chain reaction.
5. Lumbar puncture.
6. Lymph node biopsy.
7. Imaging tests:
Computed tomography.
Magnetic resonance imaging.


Can Acute Lymphocytic Leukemia Be Detected With Blood Tests?

Complete blood picture shows abnormally increased white blood cells and abnormally lowered red blood cells and platelets, which is a sign of leukemia. In addition, it also indicates leukemia by showing the presence of immature cells in the bone marrow.


Is Acute Lymphocytic Leukemia a Life-Threatening Condition?

Acute lymphocytic leukemia is a life-threatening condition, which requires immediate medical intervention. However, the prognosis is good in children, and they have a life expectancy of at least five years, whereas, in adults, the prognosis is poor.


Can Acute B-Cell Lymphoblastic Leukemia Be Cured?

With chemotherapy, acute B-cell lymphocytic leukemia usually enters the stage of remission, when the number of leukemic cells becomes nil. However, there may be a relapse in a few patients. If the remission phase lasts for more than five years or more than that, then treatment for relapse can even be cured.


Is Acute Lymphocytic Leukemia a Hereditary Condition?

Acute lymphocytic leukemia does not have a substantial genetic inheritance and does not run in families. Therefore, the chances of a person inheriting the disease from a family member are less, except for inheriting the disease from an identical twin.


How Is Acute Lymphocytic Leukemia Manifested?

- Fatigue.
- Dizziness.
- Lightheadedness.
- Pale skin.
- Red or purplish bruises.
- Shortness of breath.
- Recurrent infections.
- Excessive bleeding like bleeding in the nose, heavy menstrual bleeding, and gum bleeding.


In Which Age Group Is Acute Lymphocytic Leukemia Common?

Although people of all age groups have the risk of developing the disease, the risk is more increased in children and young adults below 20. It is estimated that more than three-fourth of all leukemia patients belong to this age group. Also, children below the age of five years are more prone to get this condition.
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Dr. Lochana .k
Dr. Lochana .k



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