Acute lymphocytic leukemia is a progressive, malignant disease characterized by large numbers of immature white blood cells that resemble lymphoblasts. These cells can be found in the blood, the bone marrow, the lymph nodes, the spleen, and other organs. It is the most common malignancy in children.

Causes

• radiation
• some toxins such as benzene
• some chemotherapy agents
• abnormalities in chromosomes
• down syndrome
• a sibling with leukemia
• chemicals & drugs

*Note: None has been definitively shown to cause lymphoblastic leukemia.

Symptoms:

• Prolonged or excessive bleeding, bruising easily
• Bleeding gums
• Nosebleeds
• Bleeding into the skin
• Menstrual periods, abnormal
• Skin rash or lesion
  • Pinpoint red spots (petechiae)
  • Bruises (ecchymoses)
• Paleness
• Fatigue
• Infection
• Sternal tenderness
• Bone pain or tenderness
  • Breastbone (sternum)
• Joint pain
  • Hip pain
  • Knee pain
  • Ankle pain
  • Foot pain over small joints of the foot
  • Shoulder pain
  • Elbow pain
  • Wrist pain
  • Hand pain over small joints of the hand
• Lymphadenopathy (enlarged glands)
• Unintentional weight loss
• Fever
• Gums, swollen
• Shortness of breath (aggravated by exercise)
• Sensations of feeling the heart beat (palpitations) with an irregular pattern

Treatments 

Acute lymphocytic leukemia is treated with a combination of anti-cancer drugs (chemotherapy). A hospitalization of 3 to 6 weeks may be necessary for initial (induction) chemotherapy, however, subsequent chemotherapy sessions may be administered on an outpatient basis. Additionally, isolation procedures may be necessary if the lymphocyte count is very low to prevent exposure to infectious agents.

Chemotherapy typically consists of a combination of 3 to 8 medications which may include: prednisone, vincristine, methotrexate, 6-mercaptopurine, and cyclophosphamide. It may also be necessary to administer blood products (e.g., packed red blood cells, platelets) to correct the anemia and low platelet count. Antibiotic therapy may be required to treat any secondary infections that develop.

After remission is achieved, chemotherapy or radiation therapy is administered in the spinal column to treat any leukemic cells that may have invaded the spinal fluid.

Subsequent therapy is directed at preventing relapse and consists of maintenance chemotherapy for up to one year. A bone marrow transplant after high-dose chemotherapy is a treatment option for cases that relapse or do not respond to other treatments.