Dr. Krishna Reddy, Consultant - Medical Oncology and Bone Marrow Transplant Physician, Manipal Hospital Vijayawada, shares some crucial clinical details about the possible treatment routes for Acute Lymphocytic Leukaemia (ALL).

At Manipal Hospital Vijayawada, our Centre of Excellence in Oncology (Cancer Care) adopts a holistic approach to provide the complete treatment of an entire spectrum of cancers at all stages. With expertise in all clinical specialties in oncology, such as medical (immunotherapy, targeted therapy, hormone therapy and chemotherapy), surgical, haematology, bone marrow transplant and radiation therapy, our proficient team of cancer specialists promises quality treatment and care.

They have years of experience in diagnosing some of the most challenging cases, staging the illness, treating with radiotherapy or medications and operating with state-of-the-art equipment and technology. To stay true to our ethos of patient centricity and clinical excellence, we prioritize quaternary care to ensure timely diagnosis and treatment of all cancers.

At Manipal Hospital Vijayawada, we have a dedicated tumour board for cancer patients. We believe that each patient is unique and thus, helps us learn about the various aspects of cancer care and treatment. With this dedicated tumour board, we encourage exhaustive discussions and studies on each case to come up with the best possible treatment. Moreover, we follow internationally approved and evidence-based chemotherapy guidelines for the treatment of haematological and solid cancers.

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Inside the hollow area of the bones is a spongy core called bone marrow. It is here, that stem cells are produced. Stem cells are immature cells that can develop into components of blood: red blood cells, which carry oxygen to the body; white blood cells or lymphocytes, which fight infection; and platelets, which helps blood to clot. Acute Lymphocytic Leukemia (ALL) is a cancer of the stem cells in the bone marrow that produce lymphocytes. The term “acute” means the cancer cells multiply rapidly, crowding out the normal cells in the blood and bone marrow. In addition, as the number of unhealthy lymphocytes in the blood and bone marrow increases, fewer red blood cells and platelets are produced. If the bone marrow is unable to produce enough healthy lymphocytes, the patient will be unable to fight infections. The leukemia cells can travel in the blood stream, or metastasize to other organs in the body where they can begin to form additional tumors. Common symptoms of ALL include persistent fever, fatigue, bleeding, easy bruising, and swollen lymph nodes. Chemotherapy is the first line of treatment, aimed at destroying the leukemia cells and allowing normal blood cells to grow. Radiation therapy, biologic therapy, and bone marrow transplantation may also be used if chemotherapy is unsuccessful. Acute lymphocytic leukemia is the most common cancer in young children. However, nearly 80% of all children with ALL can be cured.

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Eric Larsen, MD, medical director of the Maine Children's Cancer Program, discusses a large phase III study that compared outcomes between adolescent and young adult (AYA) and younger patients with high-risk acute lymphoblastic leukemia (HR-ALL).

Find out more at http://www.onclive.com/onclive....-tv/Dr-Larsen-Discus

What is Acute Lymphocytic Leukemia? (Symptoms, Causes, Treatment, Prevention) - https://healthery.com/health/a....cute-lymphocytic-leu

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ALL is a rapidly progressing cancer of bone marrow and blood. It is the most common form of childhood cancer, but it can also strike adults. The risk of ALL increases when exposed to certain chemicals and radiations. Those with human T lymphotropic virus 1 are at greatest risk.

What are the Symptoms of Acute Lymphocytic Leukemia? There are many signs and types of acute lymphocytic leukemia symptoms. Signs of ALL are painful bones, frequent bleeding, heavy sweating & paleness. It's diagnosed through blood tests, bone marrow tests and a spinal tap.

What are the Causes of Acute Lymphocytic Leukemia? 2 main causes are exposure to radiation and exposure to high levels of benzene. ALL has also been linked to genetic disorders in some cases. Some viral infections may also cause an increased risk for ALL. The risk is highest in young children, particularly those younger than five.

How is Acute Lymphocytic Leukemia Treated? Treatment usually begins with chemotherapy. Treatment also includes targeted drug therapy, radiation & stem cell transplant.

How is Acute Lymphocytic Leukemia Prevented? Avoiding exposure of radiation and dangerous chemicals can reduce risk. Consensus seems to be that there is no way to definitively prevent ALL. However, the disease is curable. There is an 85% five-year survival rate in children younger than 19. While this rate is lower in older age brackets. New methods of treatment are also leading to increased survival rates in adults.

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Acute Leukemia :
Any blood cancer with blast percentage of more than 20% is called Acute Leukemia.
Acute Lymphoblastic Leukemia is commonly seen in children between the age group of 1 to 10 years.
Acute Myeloid Leukemia is commonly seen in elderly age group.
These types of blood cancers are emergency treating diseases and if you leave these patients without treatments, they might have medical complications and sometimes have infections which may lead to death, Acute Leukemia is a medical emergency and has to be treated as quickly as possible.
Common symptoms:
1) Breathlessness due to drop in haemoglobin.
2) Bleeding Symptoms due to drop in platelets.
3) Fever due to drop in white blood cells.
4) Infections because of cancer cells
5) Anemia : because of which patients can present with shortness of breath
Both AML and ALL will have similar symptoms but AML can have a different variation in the form of enlargement of spleen, enlargement of liver, It can also be in ALL but its more common in AML
Risk factors:
As such Leukemias have no risk factors ,
But ALL’s in the pediatric age group, can be associated with genetic problems, which generally is defined as Bloom syndromes and some genetic syndromes where there is high risk of blood cancers.
How is it diagnosed? What are the treatment options?
When patients present with fever, bleeding, shortness of breath, the immediate test done is a complete blood picture. So in the CBP itself 90% of the blood cancers can be diagnosed, We cant make a diagnosis of AML or ALL but can be diagnosed of acute leukemia. Once they are diagnosed or suspected to have a blood cancer they are referred to a specialist, When they reach a specialist a battery of tests are done to diagnose the type of leukemia,
The first test done is a confirmation test or a Flow Cytometry test. This test will categorize the type of cancer whether it is ALL or AML, also their sub types.
Once a subtype is diagnosed the next is a genetic test. Some molecular tests are there to look deep into the genetic changes, these tests help see the risk category, whether it is high-risk type or low-risk category type of cancer, it will not change the first month of treatment but the drugs may change depending on if it is AML or ALL. After one month of treatment, we will assess the type of cancer whether it is high low, or intermediate, and continue treatment based on that.
When diagnosed by a primary physician for risk of leukemia it is advised to immediately see a blood cancer specialist to avoid unnecessary complications and basic most common infections can also be avoided, and the outcome will be better.

by
Dr. T. Narender Kumar
Consultant Medical & Hemato Oncologist and BMT Physician
@KIMS Hospitals Secunderabad
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