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Chapters

0:00 Introduction
1:32 Causes of Acute lymphoblastic leukemia
2:50 Symptoms of Acute lymphoblastic leukemia
3:25 Diagnosis of Acute lymphoblastic leukemia
4:29 Treatment of Acute lymphoblastic leukemia





Acute lymphoblastic leukemia (ALL) is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes.[1] Symptoms may include feeling tired, pale skin color, fever, easy bleeding or bruising, enlarged lymph nodes, or bone pain.[1] As an acute leukemia, ALL progresses rapidly and is typically fatal within weeks or months if left untreated.[11]

In most cases, the cause is unknown.[2] Genetic risk factors may include Down syndrome, Li-Fraumeni syndrome, or neurofibromatosis type 1.[1] Environmental risk factors may include significant radiation exposure or prior chemotherapy.[1] Evidence regarding electromagnetic fields or pesticides is unclear.[4][6] Some hypothesize that an abnormal immune response to a common infection may be a trigger.[4] The underlying mechanism involves multiple genetic mutations that results in rapid cell division.[2] The excessive immature lymphocytes in the bone marrow interfere with the production of new red blood cells, white blood cells, and platelets.[1] Diagnosis is typically based on blood tests and bone marrow examination.[3]

ALL is typically treated initially with chemotherapy aimed at bringing about remission.[2] This is then followed by further chemotherapy typically over a number of years.[2] Treatment usually also include intrathecal chemotherapy since systemic chemotherapy can have limited penetration into the central nervous system and the central nervous system is a common site for relapse of acute lymphoblastic leukemia.[12][13]

Treatment can also include radiation therapy if spread to the brain has occurred.[2] Stem cell transplantation may be used if the disease recurs following standard treatment.[2] Additional treatments such as Chimeric antigen receptor T cell immunotherapy are being used and further studied.[2]

ALL affected about 876,000 people globally in 2015 and resulted in about 111,000 deaths.[14][10] It occurs most commonly in children, particularly those between the ages of two and five.[15][4] In the United States it is the most common cause of cancer and death from cancer among children.[2] ALL is notable for being the first disseminated cancer to be cured.[16] Survival for children increased from under 10% in the 1960s to 90% in 2015.[2] Survival rates remain lower for babies (50%)[17] and adults (35%).[8] According to the National Cancer Intelligence Network (NCIN), generally for people with ALL: around 70 out of 100 people (70%) will survive their leukemia for 5 years or more after they are diagnosed.

ABC Action News examines five common myths about smoking and lung cancer.

Lung cancer treatment can be stressful. If surgery is an option for you, knowing what to expect from surgery can help ease that stress. This animated video explains different types of surgery for lung cancer and provides tips and guidance for patients preparing to have a procedure. For more information, please visit Lung.org/cancer-surgery.

Generously supported by Intuitive.

Targeted therapy has been revolutionary for the treatment of lung cancer leading to a reduction in mortality. In this interview, Bob T. Li, MD, MPH, Memorial Sloan Kettering Cancer Center, New York, NY, reflects on novel therapeutic targets such as KRAS, a previously "undruggable" target that is now targetable with therapies such as sotorasib and adagrasib. In addition, Dr Li explores other targeted therapies under investigation, including agents targeting EGFR, ALK, ROS, BRAF, RET, and HER2. Dr Li highlights the use of circulating tumor DNA (ctDNA) to elucidate mechanisms of drug resistance. This interview took place at the American Society of Clinical Oncology (ASCO) 2022 Annual Meeting in Chicago, IL.