Department of Medical Oncology
Leukemia: Acute Lyphoblastic (ALL)
Atrayee Basu Mallick, MD
Avnish Bhatia, MD
Christina Brus, MD
Andrew E. Chapman, DO, FACP
Neal Flomenberg, MD *
Margaret T. Kasner, MD *
Michael J. Ramirez, MD
Lewis J. Rose, MD, FACP
Mark Weiss, MD *
Allison Zibelli, MD, FACP
*Practice Focus: Hematologic Malignancies
For further information contact:
Thomas Jefferson University Hospital
Risk factors include being male, being white, age older than 70 years, past treatment with chemotherapy or radiation therapy, exposure to atomic bomb radiation, and/or having certain genetic disorders, such as Down syndrome. Once adult ALL has been diagnosed, tests are done to find out if the cancer has spread to the central nervous system (brain and spinal cord) or to other parts of the body.
Adult acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). It is also called acute lymphocytic leukemia. This type of cancer usually gets worse quickly if it is not treated. There is no standard staging system for adult ALL. The disease is classified as untreated, in remission, or recurrent.
Untreated: The ALL is newly diagnosed and has not been treated except to relieve symptoms such as fever, bleeding, or pain. The complete blood count is abnormal. More than 5% of the cells in the bone marrow are blasts (leukemia cells). There are signs and symptoms of leukemia.
Adult ALL in remission: The ALL has been treated. The complete blood count is normal. 5% or fewer of the cells in the bone marrow are blasts (leukemia cells). There are no signs or symptoms of leukemia in the brain and spinal cord or elsewhere in the body.
Recurrent Adult ALL: Recurrent ALL is cancer that has recurred (come back) after it has been treated. The ALL may come back in the blood, bone marrow, or other parts of the body.
The treatment of adult ALL is done in phases: 1) 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. 2) 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. Patients may receive chemotherapy, radiation therapy, chemotherapy with stem cell transpant, and/or targeted therapy.
Reference: National Cancer Institute.