What is acute lymphocytic leukemia (ALL)?

Acute lymphocytic 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.
  • Lymphocytic. The cancer affects the lymphocytes of a person’s white blood cells (WBCs). Another term that may be used is lymphoblastic.
  • 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, but it has high cure rates in children. Although survival rates aren’t as high when it develops in adults, they’re steadily improving.

The National Cancer Institute (NCI) estimates 5,960 people will receive a diagnosis of ALL in the United States in 2018. About 1,470 people will die from the disease in 2018.

Several factors can determine survival rates, such as age at diagnosis and subtype of ALL.

The five-year survival rate in the United States is 68.1 percent, reports the NCI. However, these numbers are steadily improving. From 1975 to 1976, the five-year survival rate for all ages was under 40 percent.

Although most people who receive a diagnosis of ALL are children, the highest percentage of Americans with ALL who pass away are between the ages of 65 and 74.

In general, about 40 percent of adults with ALL are considered cured at some point during their treatment, estimates American Cancer Society. However, these cure rates depend on a variety of factors, such as the subtype of ALL and age at diagnosis.

A person is “cured” of ALL if they’re in complete remission for five years or more. But because there’s a chance of the cancer coming back, doctors can’t say with 100 percent certainty that a person is cured. The most they can say is whether or not there are signs of cancer at the time.

In children

According to the NCI, the five-year survival rate for American children with ALL is around 85 percent. This means that 85 percent of Americans with childhood ALL live at least five years after they receive a diagnosis with cancer.

Survival rates for ALL, especially for children, continue to improve over time as new treatments are developed.

Doctors may consider many of these children to be cured of their cancer if they’ve been in complete remission for more than five years. Remission means that there are reduced signs and symptoms of the cancer.

Remission can be partial or complete. In complete remission, you have no signs and symptoms of the cancer. ALL can return following remission, but treatment can begin again.

The NCI states that among American children with ALL, an estimated 98 percent achieve remission. Remission means a child doesn’t have any signs or symptoms of the condition and blood cell counts are within normal limits.

A number of factors can affect a person’s survival rate following an ALL diagnosis, such as a person’s age or WBC count at time of diagnosis. Doctors consider each of these factors when providing a person’s outlook.

However, it’s important to remember that this outlook is the doctor’s estimation of survival given the diagnostic information they currently have.

According to the NCI, some studies have found that people have a better chance of survival if they’re 35 years old or under. In general, older adults with ALL will typically have a poorer outlook than younger people.

Children are considered higher risk if they’re over age 10.

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.

Chromosomal abnormalities

Many different types of ALL exist. 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 outlook. These include:

  • Ph1-positive t(9;22) abnormalities
  • BCR/ABL-rearranged leukemia
  • t(4;11)
  • deletion of chromosome 7
  • trisomy 8

If your doctor makes an ALL diagnosis, they’ll tell you what type of leukemia cells you have.

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 their outlook.

ALL can spread to the cerebral spinal fluid (CSF) in the body. The greater the spread to nearby organs, including CSF, the poorer the outlook.

Those with a very high WBC count at diagnosis (usually higher than 50,000 to 100,000) have a poorer outlook.

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 are listed below:

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:

  • Leukemia & Lymphoma Society
  • 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 who can put you in touch with resources and support.

Many health professionals can support you or a loved one. They include:

  • psychiatrists
  • social workers
  • dietitians
  • child life specialists
  • case managers
  • chaplains

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 complementary treatments such as herbs, vitamins, or special diets.

Create a share point for friends and loved ones

You’ll likely encounter many people who would like to help or receive updates on how you’re doing throughout your treatments.

If you’re open to sharing these updates, consider webpages such as Caring Bridge. For friends who want to help, there are resources such as Meal Train. It 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.