Acute Lymphoblastic Leukemia Pathophysiology Diagram
What Is Acute Lymphoblastic Leukemia?
Acute lymphoblastic leukemia (ALL) is a type of blood cancer that occurs when white blood cells called B cells attack healthy red blood cells called RBCs. These abnormal white blood cells release chemicals called cytokines into the bloodstream. They are known as “alloantigens” because they trigger the body’s immune system to produce antibodies against them. The process of the body attacking itself is known as “autoantibody.”
The most common ALL treatment options are chemotherapy and stem cell transplant. The cytokines released by ALL cells may help the growth and spread of cancer.
Acute Lymphoblastic Leukemia Symptoms
The following are the most common acute lymphoblastic leukemia symptoms. However, each individual may experience symptoms differently.
Loss of appetite
Weight loss for no apparent reason
Swollen lymph nodes in neck, armpit, or groin
Swollen liver or spleen
Easy bruising or bleeding
Acute Lymphoblastic Leukemia Diagnosis
The following are the most common tests for diagnosing ALL. However, each test may not be necessary for all patients and the tests may be performed in a different order. Discuss with your doctor if you believe a test is missing or should be performed.
A bone marrow biopsy is when a sample of bone marrow is taken from the hip or pelvis and checked for signs of leukemia. A small sample of bone marrow is taken with a needle and the cells are sent to a lab to be analyzed.
A lumbar puncture (also known as a spinal tap) is when a needle is inserted between the bones of your lower back to collect cerebrospinal fluid (CSF) for examination. This is a procedure used to diagnose meningitis and other neurological conditions.
A flow cytometry test measures the percentage of B cell and T cell in the blood. Cytokines from ALL may affect the number of white blood cells in the blood.
Blood test to check how well the liver and spleen are working.
ALL is often diagnosed when a person has an enlarged liver or spleen. These organs are part of the body’s immune system and help fight infection.
The level of RBCs, WBCs, platelets, and plasma in the blood is measured. ALL may affect the levels of some or all of these components of blood
Acute Lymphoblastic Leukemia Treatment
The goal of ALL treatment is to destroy ALL cells and prevent their growth. Treatment for ALL may include the following:
Chemotherapy uses anti-cancer drugs that enter the bloodstream to reach cancer cells throughout the body. They can be administered orally or intravenously (IV).
Targeted therapy uses drugs or other substances to interfere with the growth and spread of cancer cells.
Hormone therapy uses drugs to reduce the amount of hormones that promote the growth of cancer cells.
Stem cell transplant is a procedure that replaces diseased bone marrow with healthy bone marrow.
The type of treatment an individual receives will be based on various factors including the type and extent of cancer cells present, the number of diseased cells, the presence or absence of certain markers on the cells, and the health of the patient.
Treatment may consist of a combination of therapies as determined by the type and severity of ALL.
ALL cells are very fast-growing and dividing. This allows chemotherapy to kill them before they can grow and spread.
Treatment may continue until ALL cells are no longer detected or the patient becomes less responsive to treatment. This is known as disease progression.
Acute Lymphoblastic Leukemia Prognosis
The earlier ALL is diagnosed and treated the higher the chances of recovery.
Acute lymphoblastic leukemia has the following survival rates:
Childhood ALL – 85%
Adult ALL – 35%
The overall five-year survival rate of ALL is 73%.
The survival rate depends on many factors, including the following:
Type and stage of cancer
Patient’s age and general health
Supportive care, such as medication to alleviate symptoms
Acute Lymphoblastic Leukemia Complications
Complications from ALL may include, but are not limited to, the following:
Spread of disease to other parts of the body
Destruction of blood cells – leads to infection
Rejection of transplanted bone marrow and organ transplantation
Second cancers or leukemia relapse
Infection of the brain, spinal cord, or nerves
Acute Lymphoblastic Leukemia Prevention
There is currently no known way to prevent ALL.
Sources & references used in this article:
- Acute lymphoblastic leukemia: pathophysiology and current therapy. (K Imai – [Rinsho ketsueki] The Japanese journal of clinical …, 2017 – europepmc.org)
- New insights into the pathophysiology and therapy of adult acute lymphoblastic leukemia (E Jabbour, S O’Brien, M Konopleva, H Kantarjian – Cancer, 2015 – Wiley Online Library)
- Potential roles of micro RNA‐29a in the molecular pathophysiology of T‐cell acute lymphoblastic leukemia (LH Oliveira, JL Schiavinato, MS Fraguas… – Cancer …, 2015 – Wiley Online Library)
- Molecular genetics of acute lymphoblastic leukemia (SA Armstrong, AT Look – Journal of Clinical Oncology, 2005 – pdfs.semanticscholar.org)
- Cytokine release syndrome with the novel treatments of acute lymphoblastic leukemia: pathophysiology, prevention, and treatment (I Aldoss, SK Khaled, E Budde, AS Stein – Current Oncology Reports, 2019 – Springer)
- Identification of glucocorticoid-response genes in children with acute lymphoblastic leukemia (S Schmidt, J Rainer, S Riml, C Ploner, S Jesacher… – Blood, 2006 – ashpublications.org)