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ADULT ACUTE LYMPHOBLASTIC LEUKEMIA

Adult acute lymphoblastic leukemia (adult ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Adult acute lymphoblastic leukemia (also called adult acute lymphocytic leukemia) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated.

In ALL, too many stem cells develop into lymphoblasts or lymphocytes (a type of white blood cells). These cells may also be called leukemic cells. These leukemic cells are not able to fight infection very well. Also, as the number of leukemic cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. The cancer can also spread to the central nervous system (brain and spinal cord).

Risk factors for adult ALL

  • Being male
  • Being white
  • Being older than 70
  • Past treatment with chemotherapy or radiation therapy
  • Exposure to atomic bomb radiation
  • Having a certain genetic disorder such as Down syndrome

Symptoms of adult ALL

  • Weakness or feeling tired
  • Fever
  • Easy bruising or bleeding
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Shortness of breath
  • Weight loss or loss of appetite
  • Pain in the bones or stomach
  • Pain or feeling of fullness below the ribs
  • Painless lumps in the neck, underarm, stomach, or groin

Diagnostic tests and exams for adult ALL

  • Physical exam and history including checking for signs of disease, such as lumps or anything else that seems unusual
  • Blood test to check for complete blood count (CBC)
  • Peripheral blood smear to check for the presence of blast cells, number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells
  • Bone marrow aspiration and biopsy to look for abnormal cells in the bone marrow, blood, and bone
  • Cytogenetic analysis to find out if there are certain changes in the chromosomes in the lymphocytes
  • Immunophenotyping to find out if malignant (cancerous) lymphocytes began from the B lymphocytes or the T lymphocytes

Treatment of adult ALL

Treatment options depend on the following:

  • Patient`s age
  • Whether the cancer has spread to the brain or spinal cord
  • Whether the Philadelphia chromosome is present
  • Whether the cancer has been treated before or has recurred (come back)

The treatment of adult ALL usually has 2 phases:

  • Remission induction therapy: This is the first phase of treatment. Its purpose is to kill the leukemia cells in the blood and bone marrow. This puts the leukemia into remission.
  • Post-remission therapy: This is the second phase of treatment. It begins once the leukemia is in remission. The purpose of post-remission therapy is to kill any remaining leukemia cells that may not be active but could begin to regrow and cause a relapse. This phase is also called remission continuation therapy.

Treatment options include:

  • Chemotherapy: Use of drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
  • Radiation therapy: Use of high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Can be external radiation therapy or internal radiation therapy.
  • Chemotherapy with stem cell transplant: Stem cell transplant is a method of giving chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body`s blood cells.
  • Targeted therapy: Use of drugs or other substances to identify and attack specific cancer cells without harming normal cells.

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