- Acute lymphoblastic leukaemia (ALL) is a form of acute leukaemia which develops when the bone marrow produces immature blood cells that do not mature and progress rapidly
- The immature lymphoid cells are called lymphoblasts. These cells normally develop into lymphocytes, such as B-cells and T-cells, which fight infection
- ALL primarily affects Australians under the age of 15 and is most common in children under four years of age
- Each year approximately 440 Australians are diagnosed with ALL
Acute Lymphoblastic Leukaemia
Acute lymphoblastic leukaemia is a type of blood cancer which develops from immature white blood cells called lymphoblasts.
There are different subtypes of ALL which are defined based on the type of lymphocyte affected; either B-cell ALL or T-cell ALL. The World Health Organisation’s (WHO) classification system is used to classify ALL into subtypes. The three different types of ALL are:
This type of ALL is defined when early stage development of leukaemia is found in the bone marrow. Pre-B cell ALL is most common in adults.
If leukaemia is classified as B-cell ALL, this means the disease has been found in developed or more mature lymphoid cells. This is most common in young adults.
T-cell ALL is classified based on the presence of leukaemia in developing T-cells and is a less common diagnosis.
As signs and symptoms for ALL can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive an ALL diagnosis.
Symptoms may include:
Aches and pain in the bones due to cancerous cells in the bone marrow
Unexplained weight loss or loss of appetite
Pain in the chest, coughing and/or trouble breathing
Swollen, painless lymph nodes under the arms, neck or groin
Enlarged stomach due to swollen lymph nodes or spleen
Anaemia due to lack of red blood cells
Increased bleeding and bruising
The traditional cancer staging system is not used to stage ALL. Instead, the subtypes of ALL help doctors understand what your cancer looks like based on laboratory testing (including genetic testing) and the classification systems.
ALL is not usually hereditary although common inherited conditions that have been linked to ALL include Fanconi anaemia, Li-Fraumeni syndrome, Bloom syndrome, neurofibromatosis and Down syndrome.
The cause of ALL is not fully known, however there are some factors which contribute to the risk of ALL developing, including:
- Age – The risk for ALL is higher in Australians aged under 15 years of age or over 50 years
- Certain lifestyle-related factors – Such as smoking or chewing tobacco, exposure to chemicals such as benzene or large levels of radiation and previous cancer treatments with chemotherapy drugs or radiation therapy
- Genetic disorders and family history – Inherited conditions such as Down syndrome, Li-Fraumeni syndrome and Fanconi anaemia can increase the risk for ALL
Leukaemia is less common than other cancer types, affecting 1 in 61 Australians by the age of 85. ALL is the most common form of acute leukaemia in young adults, primarily affecting Australians under the age of 15. Each year approximately 440 Australians are diagnosed with ALL, with more males than females diagnosed.
There are many different tests that are used to diagnose ALL, alongside a physical examination. This may include blood tests to check your full blood count to determine if leukaemia cells are present and a bone marrow biopsy or aspiration to check for leukaemia cells within your bone marrow. Additional scans may include CT, ultrasound or MRI scans to detect if the cancer has spread elsewhere. A lumbar puncture, which involves taking a sample of cerebrospinal fluid (CSF) from your lower spine, is usually performed following an ALL diagnosis to confirm if leukaemia cells are present in the fluid surrounding your spine.
ALL and AML are two forms of acute leukaemia which develop from different types of white blood cells. ALL develops from lymphocytes such as B-cells and T-cells while AML develops from myeloid cells.
There are a number of lifestyle-related factors you can consider to reduce your risk of developing ALL, like:
- Quitting smoking – Cigarette smoking carries a significantly higher risk of developing ALL
- Getting regular exercise – Cancer Australia recommends at least 30 minutes of moderate-intensity exercise each day
- Avoiding exposure to chemicals – Such as benzene or large levels of radiation
- Eating a healthy, balanced diet – Eat a fibre-rich diet from grain and legume sources, as well as enjoy a variety of fruit (2 serves) and vegetables (5 serves) per day, limit your intake of salt and saturated fats, and avoid all processed meat.
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- Cancer Council (2020). Understanding acute leukaemia. Retrieved 4 January 2022 from https://www.cancercouncil.com.au/wp-content/uploads/2014/05/Understanding-Acute-Leukaemia-2020.pdf
- Leukaemia Foundation (2020). Acute lymphoblastic leukaemia (ALL). Retrieved 4 January 2022 from https://www.leukaemia.org.au/blood-cancer-information/types-of-blood-cancer/leukaemia/acute-lymphoblastic-leukaemia/
- Cancer Council (2020). Acute lymphoblastic leukaemia (ALL). Retrieved 4 January 2022 from https://www.cancercouncil.com.au/acute-lymphoblastic-leukaemia/
- American Cancer Society (2018). Signs and Symptoms of Acute Lymphocytic Leukemia (ALL). Retrieved 4 January 2022 from https://www.cancer.org/cancer/acute-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html
- Cancer Research UK (2018). Types | Acute lymphoblastic leukaemia (ALL). Retrieved 4 January 2022 from https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/types
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