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Acute lymphoblastic leukaemia (ALL)

Acute lymphoblastic leukaemia is a type of cancer that affects white blood cells. It progresses quickly and aggressively and requires immediate treatment. Both adults and children can be affected.

Acute lymphoblastic leukaemia is rare, with around 790 people diagnosed with the condition each year in the UK. Most cases of acute lymphoblastic leukaemia develop in children, teenagers and young adults.

Although it is rare, acute lymphoblastic leukaemia is the most common type of leukaemia that affects children. About 85% of the cases that affect children happen in those younger than 15 (mostly between the ages of 0 and 5). It affects slightly more boys than girls.

Acute lymphoblastic leukaemia is different to other types of leukaemia, including acute myeloid leukaemia, chronic lymphocytic leukaemia and chronic myeloid leukaemia.

Coronavirus advice

Get advice about coronavirus and cancer:

  • Macmillan: Coronavirus guidance for people with cancer
  • Cancer Research UK: Coronavirus and cancer

What happens in acute lymphoblastic leukaemia

All the blood cells in the body are produced by bone marrow, which is a spongy material found inside bones.

Bone marrow produces stem cells, which have the ability to develop into three important types of blood cells:

  • red blood cells – which carry oxygen around the body
  • white blood cells – which help fight infection
  • platelets – which help stop bleeding

Bone marrow does not usually release stem cells into the blood until they have become fully developed blood cells. But in acute lymphoblastic leukaemia, large numbers of white blood cells are released before they are ready. These are known as blast cells.

As the number of blast cells increases, the number of red blood cells and platelet cells decreases. This causes the symptoms of anaemia, such as tiredness, breathlessness and an increased risk of excessive bleeding.

Also, blast cells are less effective than mature white blood cells at fighting bacteria and viruses, making you more vulnerable to infection.

Symptoms of acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia usually starts slowly before rapidly becoming severe as the number of immature white blood cells (blast cells) in your blood increases.

Most of the symptoms are caused by a lack of healthy blood cells. Symptoms include:

  • pale skin
  • feeling tired and breathless
  • repeated infections over a short time
  • unusual and frequent bleeding, such as bleeding gums or nosebleeds
  • high temperature
  • night sweats
  • bone and joint pain
  • easily bruised skin
  • swollen lymph nodes (glands)
  • tummy (abdominal pain) – caused by a swollen liver or spleen
  • unintentional weight loss
  • a purple skin rash (purpura)

In some cases, the affected cells can spread from your bloodstream into your central nervous system. This can cause neurological symptoms (related to the brain and nervous system), including:

  • headaches
  • seizures or fits
  • being sick
  • blurred vision
  • dizziness

When to get medical advice

If you or your child has some or all the symptoms listed on this page, it's still highly unlikely that acute leukaemia is the cause. However, see a GP as soon as possible because any condition that causes these symptoms needs prompt investigation and treatment.

Find out more about diagnosing acute lymphoblastic leukaemia.

What causes acute lymphoblastic leukaemia

A genetic change (mutation) in the stem cells causes immature white blood cells to be released into the bloodstream.

What causes the DNA mutation to happen is not yet understood, but known risk factors include:

  • previous chemotherapy – if you've had chemotherapy to treat another type of cancer in the past, your risk of developing acute lymphoblastic leukaemia is increased. The risk relates to certain types of chemotherapy medicine, such as etoposide, and how much treatment you had
  • smoking – smokers are much more likely to develop acute leukaemia than non-smokers, and studies have shown that parents who smoke in the home may increase the risk of leukaemia in their children
  • being very overweight (obese) – some studies have shown that people who are very overweight have a slightly higher risk of developing leukaemia than those who are a healthy weight
  • genetic disorders – a small number of cases of childhood acute lymphoblastic leukaemia are thought to be related to genetic disorders, including Down's syndrome
  • having a weakened immune system – people with lowered immunity (as a result of having HIV or AIDS or taking immunosuppressants) have an increased risk of developing leukaemia

Environmental factors

Extensive research has been done to determine whether the following environmental factors could be a trigger for leukaemia:

  • living near a nuclear power station
  • living near a power line
  • living near a building or facility that releases electro-magnetic radiation, such as a mobile phone mast

There's currently no firm evidence to suggest that any of these environmental factors increases the risk of developing leukaemia.

Cancer Research UK has more information about acute lymphoblastic leukaemia risks and causes.

Treating acute lymphoblastic leukaemia

As acute lymphoblastic leukaemia is an aggressive condition that develops quickly, treatment usually begins a few days after diagnosis.

Treatment is usually done in the following stages: 

  • remission induction – the first stage of treatment aims to kill the leukaemia cells in your bone marrow, restore the balance of cells in your blood and resolve any symptoms you may have
  • consolidation – this stage aims to kill any remaining leukaemia
  • maintenance – this stage involves taking regular doses of chemotherapy medicines to prevent leukaemia from returning

Chemotherapy is the main treatment for acute lymphoblastic leukaemia. Other treatments you may need include antibiotics and blood transfusions. Sometimes a stem cell transplant may also be needed to achieve a cure.

Find out more about treating acute lymphoblastic leukaemia.

Complications of acute lymphoblastic leukaemia

If a cure for acute lymphoblastic leukaemia is not possible, there's a risk that the lack of healthy blood cells can make the person:

  • extremely vulnerable to life-threatening infections (because they do not have enough healthy white blood cells to fight infections)
  • prone to uncontrolled and serious bleeding (because there are not enough platelets in their blood)

These two complications, and others, are discussed further in complications of acute lymphoblastic leukaemia.

Outlook

One of the biggest factors that affects the outlook for people with acute lymphoblastic leukaemia is age. The younger a person is when they are diagnosed and treatment begins, the better the outlook.

From the available data in England it is estimated that:

  • in those aged 14 or younger, more than 9 in 10 will survive leukaemia for 5 years or longer after diagnosis
  • in those aged 15 to 24, almost 7 in 10 will survive leukaemia for 5 years or longer after diagnosis
  • in those aged 25 to 64, almost 4 in 10 will survive leukaemia for 5 years or longer after diagnosis
  • in those aged 65 or older, almost 15 in 100 will survive leukaemia for 5 years or longer after diagnosis

Help and support

Find more information about cancer.

If you or a family member has been diagnosed with acute lymphoblastic leukaemia, Leukaemia Care provides further information, advice and support.

Call Leukaemia Care's free helpline on 08088 010 444 or email: support@leukaemiacare.org.uk

The charity Cancer UK also has more information about acute lymphoblastic leukaemia.

HealthUnlocked contains information from NHS Digital, licensed under the current version of the Open Government Licence

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1,898 public posts

Webinar 3.30pm, Tuesday 6th April - Acute lymphoblastic leukaemia (ALL) treatment update

Please join us for the 3rd in the series of acute leukaemia treatment updates. This webinar will update on how ALL is treated today and what is on the horizon: how is a therapy chosen, how is prognosis determined and what level of involvement should patients expect in their care decisions. The webinar
Please join us for the 3rd in the series of acute leukaemia treatment updates. This webinar will update on how ALL is treated today and what is on the horizon: how is a therapy chosen, how is prognosis determined and what level of involvement should patients expect in their care decisions. The webinar
HAIRBEAR_UKAdministrator
in Leukaemia CARE

Ppfe

She had a bone marrow transplant 11 yrs ago as she had acute lymphoblastic leukaemia. Is there anyone out there in the same situation?
She had a bone marrow transplant 11 yrs ago as she had acute lymphoblastic leukaemia. Is there anyone out there in the same situation?
Kcn3
in British Lung Foundation

Acute lymphoblastic leukaemia

Hi is the forum still active for Acute lymphoblastic leukaemia on this site. I can only see CLL posts. Thanks Hayley
Hi is the forum still active for Acute lymphoblastic leukaemia on this site. I can only see CLL posts. Thanks Hayley
Cyprusfan
in Leukaemia CARE
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Childhood ALL video update by Dr Sara Ghorashian from the 2019 American Society of Hematology (ASH)

In this video interview Dr Sara Ghorashian describes the remaining challenges in the treatment of childhood acute lymphoblastic leukaemia (ALL), and how these could be addressed. https://youtu.be/o4R9V5OeQoU
In this video interview Dr Sara Ghorashian describes the remaining challenges in the treatment of childhood acute lymphoblastic leukaemia (ALL), and how these could be addressed. https://youtu.be/o4R9V5OeQoU
HAIRBEAR_UKAdministrator
in Leukaemia CARE

Video Interview: Acute lymphoblastic leukaemia (ALL) research updates from ASH 2019. How genetic information aids diagnosis and treatment

lymphoblastic leukaemia (ALL) at ASH 2019. https://youtu.be/9vzGoSHJEX4 In the second video Professor Anthony Moorman discusses in more detail the different types of genetic abnormalities, and how their identification can define prognosis and use of different treatments to help clinicians to design
lymphoblastic leukaemia (ALL) at ASH 2019. https://youtu.be/9vzGoSHJEX4 In the second video Professor Anthony Moorman discusses in more detail the different types of genetic abnormalities, and how their identification can define prognosis and use of different treatments to help clinicians to design
HAIRBEAR_UKAdministrator
in Leukaemia CARE

An Investigation into the Quality of Life and Dietary Behaviours of Young Adult Cancer Survivors

When I was fifteen years old I was diagnosed with Acute Lymphoblastic Leukaemia and received three and half years of chemotherapy treatment. I will always be incredibly grateful for the amazing care and support that I received and will remain inspired by the many people I met along the way.
When I was fifteen years old I was diagnosed with Acute Lymphoblastic Leukaemia and received three and half years of chemotherapy treatment. I will always be incredibly grateful for the amazing care and support that I received and will remain inspired by the many people I met along the way.
HAIRBEAR_UKAdministrator
in Leukaemia CARE

One-to-one buddy support

We have trained buddies to support those diagnosed with: myeloid leukaemia (AML) lymphoblastic leukaemia (ALL) promyelocytic leukaemia (APL) Chronic lymphocytic leukaemia (CLL) Chronic myeloid leukaemia (CML) Chronic myelomonocytic leukaemia
We have trained buddies to support those diagnosed with: myeloid leukaemia (AML) lymphoblastic leukaemia (ALL) promyelocytic leukaemia (APL) Chronic lymphocytic leukaemia (CLL) Chronic myeloid leukaemia (CML) Chronic myelomonocytic leukaemia
HAIRBEAR_UKAdministrator
in Leukaemia CARE

Sad news

It has taken me some time to write this... but I hope my husband’s journey with MPN is perceived overall a message hope to others. He was diagnosed with PV aged 46 and had a great quality of life for 28 years ,needing only phlebotomy -initially weekly but eventually every six weeks or so . He progressed
It has taken me some time to write this... but I hope my husband’s journey with MPN is perceived overall a message hope to others. He was diagnosed with PV aged 46 and had a great quality of life for 28 years ,needing only phlebotomy -initially weekly but eventually every six weeks or so . He progressed
Joe500
in MPN Voice

Webinar 3.30pm, Thursday 11th March - Acute myeloid leukaemia (AML) treatment update

Please join us for our 2nd webinar in the acute leukaemia treatment updates series. This webinar will update on how AML is treated today and what is on the horizon: how is a therapy chosen, how is prognosis determined and what level of involvement should patients expect in their care decisions. The
Please join us for our 2nd webinar in the acute leukaemia treatment updates series. This webinar will update on how AML is treated today and what is on the horizon: how is a therapy chosen, how is prognosis determined and what level of involvement should patients expect in their care decisions. The
HAIRBEAR_UKAdministrator
in Leukaemia CARE

Webinar 9.30am, Wednesday 3rd March - Acute promyelocytic leukaemia (APL) treatment update

Please join us for the 1st in our series of free treatment updates in acute leukaemia. This webinar will update on how APL is treated today and what is on the horizon: how is a therapy chosen, how is prognosis determined and what level of involvement should patients expect in their care decisions. The
Please join us for the 1st in our series of free treatment updates in acute leukaemia. This webinar will update on how APL is treated today and what is on the horizon: how is a therapy chosen, how is prognosis determined and what level of involvement should patients expect in their care decisions. The
HAIRBEAR_UKAdministrator
in Leukaemia CARE

Anti inflammatory eating..

Morning.. I am a MF patient, (52 working full time), and for a while have been interested in how nutrition can help me. I can be very good about a varied diet, and then get bored of it, or the perceived effort of planning and doing etc.... However lockdown has made eating well harder, shopping online
Morning.. I am a MF patient, (52 working full time), and for a while have been interested in how nutrition can help me. I can be very good about a varied diet, and then get bored of it, or the perceived effort of planning and doing etc.... However lockdown has made eating well harder, shopping online
Mrs_Average
in MPN Voice

ET OR MYELOFIBROSIS

Hi! I am new to this. You guys Who have ET, did you have any raising levels in LDH? Or anything else other than high platelets? How is the prognosis with prefibrotic myelofibrosis? Do everyone get myelofibrosis? Thank you!
Hi! I am new to this. You guys Who have ET, did you have any raising levels in LDH? Or anything else other than high platelets? How is the prognosis with prefibrotic myelofibrosis? Do everyone get myelofibrosis? Thank you!
Johan2021
in MPN Voice

Organic apple cider vinegar "unpasteurized and unfiltered" ?

I am starting to use a very small quantity (spoons full ) of organic apple cider vinegar to spice-up vegetable puree. Can I use the "organic apple cider vinegar" which "unpasteurized and unfiltered" ? I have CLL under near normal CBC control with IMBRUVICA. Also, what if any benefit would any small
I am starting to use a very small quantity (spoons full ) of organic apple cider vinegar to spice-up vegetable puree. Can I use the "organic apple cider vinegar" which "unpasteurized and unfiltered" ? I have CLL under near normal CBC control with IMBRUVICA. Also, what if any benefit would any small
janvog
in CLL Support

WARWICK's ASCT Journey Begins Today...

Post by MPN-MATE Admin » Mon Feb 08, 2021 4:23 pm Hey everyone... :D As the subject of this Post is about Warwick's Allogenic Stem Cell Transplant journey, he will come back as he progresses through each stage of this journey to share the experience w/ ALL MPNers, who might have an interest... I met
Post by MPN-MATE Admin » Mon Feb 08, 2021 4:23 pm Hey everyone... :D As the subject of this Post is about Warwick's Allogenic Stem Cell Transplant journey, he will come back as he progresses through each stage of this journey to share the experience w/ ALL MPNers, who might have an interest... I met
socrates_8
in MPN Voice

Thalassemia beta trait and elevated platelets

I was referred to a haematologist last year as the blood test results from my annual health screen came back with some abnormal results. I have thalassemia trait so my blood results are never normal but my GP noted that my platelets were elevated at 489. I looked back at some older blood tests and
I was referred to a haematologist last year as the blood test results from my annual health screen came back with some abnormal results. I have thalassemia trait so my blood results are never normal but my GP noted that my platelets were elevated at 489. I looked back at some older blood tests and
nutter1234
in MPN Voice

3 x Articles from 'The Conversation'

[u]Coronavirus might become endemic – here’s how.[/u] Endemic viruses are those that have constant presence within a geographical area. Such viruses are all around us, though they vary by location. Examples in Europe and North America include the rhinovirus (a cause of the common cold) and influenza
[u]Coronavirus might become endemic – here’s how.[/u] Endemic viruses are those that have constant presence within a geographical area. Such viruses are all around us, though they vary by location. Examples in Europe and North America include the rhinovirus (a cause of the common cold) and influenza
2greys
in British Lung Foundation

Newly diagnosed with myelofibrosis

Hallo. I am newly diagnosed with myelofibrosis. I was called to be told a week ago. I’ve been in and out of shock since and now so frightened I can’t sleep. I have no information, and have been googling prognoses and crying constantly. I don’t know what I’m dealing with at all. Will I be around to see
Hallo. I am newly diagnosed with myelofibrosis. I was called to be told a week ago. I’ve been in and out of shock since and now so frightened I can’t sleep. I have no information, and have been googling prognoses and crying constantly. I don’t know what I’m dealing with at all. Will I be around to see
LuluCosson
in MPN Voice

Top-speed antibody development.

The development of biopharmaceuticals is a long and expensive process. A decade or more can elapse between the discovery of a new protein-based active ingredient and the release of a new drug. One major hurdle on this journey is the passage from the lab to clinical trials. As a rule, it takes between
The development of biopharmaceuticals is a long and expensive process. A decade or more can elapse between the discovery of a new protein-based active ingredient and the release of a new drug. One major hurdle on this journey is the passage from the lab to clinical trials. As a rule, it takes between
2greys
in British Lung Foundation

Should I push harder for tests to rule out essential thrombocythemia?

I have a complex medical history, mixed connective tissue disease, RA, eosiniophilc esophagitis, hypopituitarism, adrenal insufficiency, exercise anaphylaxis, a bunch of things that are unrelated, some serious, some annoyances. I have extremely high bone density, so have degenerative spinal disease
I have a complex medical history, mixed connective tissue disease, RA, eosiniophilc esophagitis, hypopituitarism, adrenal insufficiency, exercise anaphylaxis, a bunch of things that are unrelated, some serious, some annoyances. I have extremely high bone density, so have degenerative spinal disease
lilyak
in MPN Voice

Webinar - Living well with CLL - 3.30pm Monday 15th Feb

Hello friends Lymphoma Action and Leukaemia Care are back with our next joint webinar on Monday 15th February 2021 at 3,30pm Please join us to explore strategies that may aid you to live well with a CLL diagnosis, regardless of what stage of the journey you may be at. The experienced panel of clinicians
Hello friends Lymphoma Action and Leukaemia Care are back with our next joint webinar on Monday 15th February 2021 at 3,30pm Please join us to explore strategies that may aid you to live well with a CLL diagnosis, regardless of what stage of the journey you may be at. The experienced panel of clinicians
HAIRBEAR_UKAdministrator
in Leukaemia CARE
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