Acute Lymphocytic Leukemia

Acute Lymphocytic Leukemia – General Information

Acute Lymphocytic Leukemia is an appropriate form of Acute Myeloid Leukemia. This disease is characterized by a fast proliferation of abnormal cells that accumulates in the bone marrow, and this can lead to a deficient production of any blood cells. It is considerate a progressive disease in which there are some immature blood stem cells in the blood and bone marrow, the cells being those which have the purpose to produce to the granulocytes or monocytes, which are the types of white blood cells that prevent any infections in the body. In this type of leukemia, the leukemic blasts don’t mature and become numerous, being abnormal. Leukemia can appear in adults, but also in children.

Acute Lymphocytic Leukemia is a treatable and curable cancer but only a few patients are cured with the standard chemotherapy. The leukemia is treated in the first place with chemotherapy  to induce a remission of the cancer, but, in some cases, some patients can go on to receive a hematopoietic stem cell transplant. In some cases of leukemia, there are too many cells that develop into abnormal red blood cells or platelets. These types of white blood cells, red blood cells, or platelets are commonly called leukemia cells or leukemia blasts, and are types of cells that can’t do their function and can build up in the bone marrow and in blood, and there is no place for the healthy blood cells. Then the leukemia takes place, with infection, anemia, and easy bleeding, and can also spread to the other parts of the body, including the CNS (central nervous system), brain, spinal cord, and skin.

Acute Lymphocytic Leukemia – Symptoms

There can be early signs of Acute Lymphocytic Leukemia and are similar to flu or other usual diseases including fever, weakness, loss of weight and appetite, and aches and pain in the bones or joints. The main symptoms of Acute Lymphocytic Leukemia are because of an increased number of abnormal white blood cells on the wrong place or they interfere with the production of normal blood cells in the bone marrow. A lack of white blood cells, which are the cells involved in fighting pathogens, can be suppressed by the leukemic blasts and this can cause the person's immune system to start attacking other body cells, and can also appear the risk of developing infections. A lack of red blood cells cause anemia and the common symptoms are fatigue, paleness, and shortness of breath. A lack of platelets can provoke to easy bruising or bleeding with minor trauma.

There are some official symptoms of this cancer and include fever, fatigue, weight loss or loss of appetite, shortness of breath with exertion, anemia, easy bruising or bleeding, the appearing of some flat, oval sized spots under the skin caused by bleeding, bone pain and joint pain and the recurring of infections.
In some cases, patients suffering with Acute Lymphocytic Leukemia can present symptoms like some swelling of the gums because of infiltration of the leukemic blasts into the gum tissue. Less encountered symptoms can include dizziness, swollen tonsils, enlarged liver and spleen, frequent mood swings, neurological symptoms.

Acute Lymphocytic Leukemia – Treatment

In most of the cases, the main treatment for curing Acute Lymphocytic Leukemia is chemotherapy which consists in combination of medications, including drugs like daunorubicin, cytarabine, idarubicin, thioguanine, etoposide, or mitoxantrone, anabolic steroids. Daunorubicin is a cytotoxic agent and its effects prevent the cancer cells to reproduce, which leads to the death of the cancer cells, and this type of drug has to be carefully prescribed, because it depends on the patient’s medical condition. Cytarabine is an antimetabolite and works by binding to the DNA of the leukemic cancer cells, which leads to slow down their reproduction and their growth. It can also have the effect of inhibitor on the enzymes that help the cancer cell reproduction. Thioguanine is an antineoplastic and it also works by stopping the cell protein growth. Mitoxantrone is an antineoplastic agent and this drug interferes with cell reproduction and growth, which leads to the reduction of the number of cancer cells in the body.

Acute Lymphocytic Leukemia is also treated with the 2 stage therapy, induction and consolidation therapy, and helps to get the leukemia in remission. The first stage of the treatment, standard induction therapy, in the curing of Acute Lymphocytic Leukemia, includes two types of drugs, an anthracycline, also known as daunorubicin or idarubicin, and it is used in combination with a nucleoside analogue of this medicine called cytosine arabinoside. In the induction stage of the treatment, there can be also includes anti vomiting drugs, but is usually taken during a hospital stay for the therapy, and can last for almost a month. Because the chemotherapy medications may kill normal bone marrow and leukemic blasts almost in the same way, the most common side effects, including vomiting and nausea, are the appearing of a temporary reduction of the white blood cells, red blood cells, and platelets. The lack of white blood cells, red blood cells, and platelets can lead to several effects including easy bruisability and spontaneous bleeding, anemia, fatigue, shortness of breath, and a lack of energy, and a higher risk of infection development because of the lack of white cells that lowers the immunity of the body, but these symptoms can be treated by routine blood cells transfusion. The second stage in treating Acute Lymphocytic Leukemia, is consolidation, and consists in giving to the patient repeated trials of chemotherapy, as soon he seems to have signs of leukemia remission. This way of treatment is used to erase any microscopic signs of leukemia that aren’t detectable using the common diagnostic methods.

The blood stem cell transplant can be a first option in the treatment of Acute Lymphocytic Leukemia, instead of using chemotherapy, when the patient the patient has been diagnosed with leukemia, and also presents any adverse prognostic features. This type of treatment can also be used to cure Acute Lymphocytic Leukemia when it has recurred after a standard chemotherapy treatment. If one of the patients is old, there is a low chance to cure Acute Myeloid Leukemia and it should be taken in consideration palliative and supportive attention, which is a reasonable option.