Acute lymphoblastic leukemia (ALL) is a form of cancer. Each part of its name tells you something about the cancer itself:
- Acute: The cancer is often fast-growing and requires early detection and treatment. Without treatment, bone marrow cells can’t properly mature, and a person won’t have enough healthy, mature bone marrow. Bone marrow is replaced by rapidly growing abnormal lymphocytes.
- Lymphoblastic: The cancer affects the lymphocytes of a person’s white blood cells. Another term that may be used is lymphocytic.
- Leukemia: Leukemia is a cancer of the blood cells.
Several types of ALL exist. The survival rates for ALL depend on what type a person has. ALL is the most common childhood cancer and has high cure rates in children. However, survival rates aren’t as high when it develops in adults.
The survival rates vary based on how old you are when you’re diagnosed. According to the National Cancer Institute, the five-year survival rate for children with ALL is 85 percent. This means that 85 percent of people with childhood ALL live at least five years after they were diagnosed with cancer. Doctors consider many of these children to be cured of their cancer, as ALL isn’t likely to recur after the five-year mark.
According to St. Jude Children’s Hospital, an estimated 98 percent of children with ALL are considered in remission several weeks after starting treatments. Remission means a child doesn’t have any signs or symptoms of the condition and blood cell counts are within normal limits. However, ALL can return following remission.
The five-year survival rate for adults and children combined is 69 percent. However, these numbers are improving regularly. From 1975 to 1977, the five-year survival rate for all ages was 41 percent. Survival rates for ALL, especially for children, continue to improve over time as new treatments are developed. According to the National Cancer Institute, the highest percentage of people with ALL who pass away are between the ages of 65 and 74.
A number of factors can affect a person’s survival rate following an ALL diagnosis. A doctor will take into account each of these factors when providing a prognosis. However, it’s important to remember that a prognosis is your doctor’s estimation of survival given the diagnostic information they currently have.
According to the National Cancer Institute, some studies have found that people have a better chance of survival if they are 35 years old or under. Children are considered higher risk if they’re over age 10. Older adults with ALL will typically have a poorer prognosis than younger people.
People with cell subtypes including pre-B, common, or early pre-B are generally considered to have better survival chances than those with mature B-cell (Burkitt) leukemia.
Many different types of ALL exist, and the cancers that cause ALL can create different changes to a person’s chromosomes. A doctor called a pathologist will examine the cancerous cells under a microscope.
Several different types of chromosomal abnormalities are associated with a poorer prognosis. These include:
- Ph1-positive t(9;22) abnormalities
- BCR/ABL-rearranged leukemia
- deletion of chromosome 7
- trisomy 8
Your doctor should tell you what type of leukemia cells you have.
Responsiveness to therapy
People who respond quickly to treatments for ALL may have a better outlook. When it takes longer to reach remission, the outlook is often not as good. If a person’s treatment takes longer than four weeks to go into remission, this can affect prognosis.
Spread to nearby organs
ALL can spread to the cerebral spinal fluid (CSF) in the body. The greater the spread to nearby organs, including the CSF, the poorer the outlook.
White blood cell count at time of prognosis
Those with a very high white blood cell count at diagnosis (usually higher than 50,000–100,000) have a poorer prognosis.
Using all of these factors, a doctor can give their best guess of prognosis.
Coping and support
Hearing a doctor tell you that you have cancer is never easy. However, many types of ALL are highly treatable. While you undergo treatments, there are many avenues of support available to help you through this journey. Some of the methods you can use include:
Research the disease. Learning more from respected, well-researched organizations can help you become as informed as possible about your condition and care. Examples of excellent resources include the Leukemia & Lymphoma Society and the American Cancer Society.
Reach out to your healthcare team. Cancer treatment often involves a team approach to your care. Many cancer facilities have cancer navigators that can put you in touch with resources and support. Many health professionals, including psychiatrists, social workers, dietitians, child-life specialists, case managers, and chaplains, can support you or a loved one.
Consider complementary treatments. Treatments that promote relaxation and stress relief can complement your medical treatments. Examples could include massage or acupuncture. Always talk to your doctor before beginning any alternative treatments such as herbs, vitamins, or special diets.
Create a share point for friends and loved ones. You will likely encounter many people who would like to help or receive updates on how you are doing throughout your treatments. If you are open to sharing these updates, consider webpages such as Caring Bridge. For friends who want to help, there are resources such as Meal Train, which allows friends to sign up for meal deliveries.
It’s important to remember there are many friends, family members, and organizations who wish to help you in your treatment and recovery from ALL.