Blood cells are produced from bone marrow of your body. Normally bone marrow produces fixed number of red blood and white blood cells. But due to defective gene mutation, bone marrow would start producing immature white blood cells (lymphoblast) in large number. These abnormal white blood cells will crowd up the healthy cells restricting the normal function. This would lead to acute lymphoblastic leukemia, a type of blood cancer.
Since the disease progress quickly creating more number of immature white blood cells, it is known as “acute” (rapidly). ALL is a common blood cancer that occurs in children but it can occur in adults also. Early intervention and quick treatment can give better results. If left untreated, death can occur in few months due to Acute Lymphoblastic Leukemia(ALL).
If a child has developed ALL, he/she may have symptoms like bleeding of gums, fever, sharp pain in the bones, bleeding of nose, swollen lymph nodes of neck, underarm and extreme tiredness. These are only common symptoms and the signs may differ from one individual to another. The skin of the affected person will become pale (due to reduced RBC) and sometimes they can feel breathless. Some of the symptoms given above may resemble flu but the signs would improve eventually if it is due to flu.
ALL develops due to defective cell multiplication. Normally older cells would die once newer cells are formed. But in a person with ALL, abnormal blood cell production will be there giving rise to increased WBC count. The bone marrow starts producing immature white blood cells or lymphoblast that causes cancer. It is not clear why certain people develop defective DNA mutation and others are not.
Who are at risk? :
A child/adult with genetic disorder like Down’s syndrome, history of cancer, and those who are exposed to radiation treatment and those whose sibling has ALL are prone to develop acute lymphoblastic leukemia. Exposure to poisonous chemicals, cigarette smoke and cleaning detergents and belonging to white race increases the chance of getting ALL.
Your doctor will collect complete medical history and order for series of tests like blood profile (to check the white blood count), imaging tests like X-ray or computerized tomography, bone marrow test (using aspiration) to detect any changes in the blood cells. For some people, lumbar puncture is done to collect the spinal fluid which is then tested to detect any changes.
There are several phases/types of treating ALL. In induction therapy the goal of the treatment is to kill the cancer causing cells present in the bone marrow. During consolidation method which is done after induction treatment, leftover cancerous cells present in the brain or spinal cord is totally destroyed. Next is the maintenance therapy in which treatment is given to prevent cancer cells from growing afresh, after killing the entire set of cancerous cells.
For some people, special preventive treatment is given to destroy all the leukemia cells present in the spinal cord. Chemotherapy is the first line treatment for leukemia in which medications like Etoposide, cytarabine, oncovin and methotrexate are given in the form of injection or oral pills to destroy cancer cells. Targeted drugs like Gleevec, sprycel or Tasigna are given to destroy special abnormal cancer cells and this method is often combined with maintenance phase.
Radiation is given using high powered energy beams to kill the cancer causing cells completely. In some cases, stem cell transplantation is done to reduce the remission rate in children. Healthy stem cells are established in the body after destroying cancer causing cells in the bone marrow. But you need to find a suitable donor to donate healthy stem cells for the patient.
Recovery depends on the factor of age, health condition, location of leukemia and count of white blood cells and type of ALL. Very often children would recover completely by undergoing early treatment when compared with older adults. It is unfortunate to note that 8 out of 10 adults will have relapse (formation of fresh cancer cells) after remission (absence of symptoms) once they complete the course of treatment. Hence the chance of overall cure rate is very low in ALL.
Coping and Support :
It might take 2 or even 3 years to destroy the cancer cells totally from the body. Children cannot attend school and other normal activities during the first 6 months of induction phase. During the maintenance phase they can get back to school after getting clearance from the doctor.
As a parent, you need to gather enough information about ALL and select expert team of doctors for your child. You can get in touch with numerous cancer institute and American cancer society any time. Encourage your child to participate in activities arranged for these children so that they can spend time together with other children who have similar problems.