Acute lymphocytic leukemia: what it is, symptoms and treatment

Acute lymphoblastic leukemia (ALL), also known as acute lymphoblastic leukemia, is a type of cancer related to white blood cells, especially lymphocytes, which begins in the bone marrow, responsible for producing and releasing lymphocytes into the bloodstream, which are cells that they act in the body’s defense against infections.

This cancer is the most common type of leukemia in children, and is characterized by the presence of excessive unmatured lymphocytes in the blood, which can invade other organs of the body such as lymph nodes, liver, spleen or brain, leading to the rapid onset of symptoms such as bleeding in the gums, fever, bone pain or frequent infections, for example.

Although it develops very quickly, acute lymphoblastic leukemia has a greater chance of being cured when treatment is started early, with more than 90% of children who are diagnosed with ALL and receive the correct treatment achieving complete remission of the disease.

Symptoms of acute lymphocytic leukemia

Early symptoms of acute lymphocytic leukemia include:

1. Easy bleeding gums;
2. Frequent or severe bleeding from the nose;
3. Frequent infections, which do not disappear or often reappear, such as tonsillitis or pneumonia;
4. Fever above 38ºC;
5. Pain in bones or joints;
6. Difficulty breathing and feeling short of breath;
7. Excessive tiredness and lack of energy;
8. Weight loss without apparent cause;
9. Pale skin;
10. Night sweats;
11. Lump formation, which is the enlargement of lymph nodes around the neck, armpits, abdomen or groin;
12. Ease of having purple spots on the skin;
13. Abdominal pain, caused by swelling of the liver or spleen.

Additionally, when the affected cells reach the brain, it can cause symptoms such as headache, blurred vision, dizziness or seizures.

Generally, acute lymphocytic leukemia is easy to identify because the symptoms appear almost at the same time, which makes it possible to differentiate it from another type of leukemia, chronic lymphocytic leukemia, in which the symptoms appear in isolation, or may not even exist, being only identified due to changes in the blood count during routine examinations. Understand what chronic lymphocytic leukemia is and how to identify it.

Therefore, to make the diagnosis as early as possible, it is important to consult a clinician as soon as any of the symptoms appear to request a blood test and identify if there are changes that should be evaluated.

How to confirm the diagnosis

The diagnosis of acute lymphoblastic leukemia is made by an onco-hematologist or hematologist based on the symptoms presented and the results of the blood count and the differential count in the blood smear, in which many lymphocytes are verified and, in some people, a decrease in concentration can still be seen. hemoglobin, red blood cells or decreased platelets. Learn how to interpret the blood count.

Make an appointment with the hematologist in the region closest to you:

In addition, the doctor must request a bone marrow biopsy to classify the blood cells and check their size, shape, genetic and molecular characteristics, which will help the doctor determine the type of treatment to be carried out. Understand how a bone marrow biopsy is performed.

The doctor may also order other tests such as X-rays, computed tomography or ultrasound to check whether the cancer has spread to other organs, and a lumbar puncture, which will make it possible to analyze whether cancer cells have reached the brain or other parts of the central nervous system.

Possible causes

Acute lymphocytic leukemia is caused by changes or mutations in stem cells, causing the bone marrow to release unmatured lymphocytes into the bloodstream.

The causes of DNA mutations are not yet completely known, but some factors may contribute to these changes, such as:

• Have previously undergone chemotherapy treatment;
• Genetic diseases, such as Down syndrome;
• Radiation exposure.

In addition, having a weakened immune system due to HIV infection or taking immunosuppressant medications also increases the risk of developing acute lymphocytic leukemia.

How the treatment is carried out

The treatment of acute lymphocytic leukemia is carried out by an oncologist or hematologist, and includes:

• Chemotherapy: uses chemotherapy drugs such as methotrexate, for example, directly into the vein, to destroy cancer cells in the body;
• Target therapy: made with the use of medicines such as dasatinib, for example, to block specific abnormalities present in cancer cells, causing the destruction of these cells. This type of treatment can be done in combination with chemotherapy;
• Radiotherapy: done with the use of high-power radiation, indicated when cancer cells have reached the brain or other part of the central nervous system, with the aim of eliminating cancer cells;
• Bone marrow transplant: This type of treatment aims to restore the health of the bone marrow, replacing the diseased bone marrow with a healthy one, which can be that of a bone marrow donor. Understand how bone marrow transplantation is performed;
• Gene therapy of CAR-T cell: consists of altering the immune system so that tumor cells are easily recognized and eliminated from the body. See how CAR-T cell gene therapy works.

Generally, the treatment of acute lymphoblastic leukemia is more intense and aggressive in the first months, being reduced over 2 or 3 years.

Furthermore, during the treatment of acute lymphoblastic leukemia, other treatments may be necessary, such as the use of antibiotics or blood transfusions, depending on the doctor’s assessment.

Read too: Cancer remission: what it is and when it is achieved