Multiple indicators of leukemia are present in today’s children. The four major indicators of childhood leukemia include Acute Lymphocytic Leukemia, Chronic Lymphocytic Leukemia, Acute Myelogenous Leukemia, and Chronic Myelogenous Leukemia. Acute Myelogenous Leukemia (AML) is a malignant neoplastic disease of the bone and bone marrow (“Acute Myelogenous Leukemia” 1). Compared to AML, where 10% of patients are children, Acute Lymphocytic Leukemia accounts for 80% of all childhood acute leukemias. ALL occurs in children aged three through seven (Zieve 1). Acute Lymphocytic Leukemia (ALL) involves six processes from the beginning to the end of the disease; understanding ALL requires learning about its causes, symptoms, diagnosis, treatment, and side effects.
Since ALL is the most common form of childhood acute leukemia, one needs to gather every bit of information available about this disease. This particular childhood leukemia is a type of blood cancer (“Acute Lymphocytic Leukemia” 1). ALL results from an acquired genetic damage to the DNA of a single cell in the bone marrow (Bellenir 592). Acute Lymphoblastic Leukemia and Acute Lymphoid Leukemia are synonyms for Acute Lymphocytic Leukemia (Bellenir 592). Throughout the United States in 2010, 5,330 people were expected to be diagnosed with ALL (“Acute Lymphocytic Leukemia” 1).
Acute Lymphocytic Leukemia results when the body produces a large quantity of immature white blood cells (Hughes). ALL can arise in the bone, bone marrow, lymph nodes, and spleen (Zieve 1). “ALL starts with a change to a single cell in the bone marrow” (“Acute Lymphocytic Leukemia” 1). As with any disease, risk factors are associated with ALL. If an individual has had exposure to high doses of radiation therapy, they are at a high risk for developing ALL (“Acute Lymphocytic Leukemia” 1). “ALL occurs at different rates in different geographic locations” (“Acute Lymphocytic Leukemia” 2). However, people who live in more developed countries are also at a higher risk of developing ALL (Bellenir 592). Individuals who have Down syndrome or other genetic disorders or have a sibling with leukemia are at greater risk of developing ALL (Zieve 1).
All patients experience many different symptoms during the disease. People who are experiencing ALL may come to feel pain in the arms, legs, and back (“Acute Lymphocytic Leukemia” 2). Individuals may also notice small red spots under the skin and bruise-like marks, called petechiae, on the skin for no apparent reason (Bellenir 594). Detecting swollen lymph nodes is not an everyday activity for an average person; however, if an individual notices “painless lumps in the neck, underarm, abdomen or groin”, they should seek immediate medical attention (Zieve 1). An ALL patient may experience headaches, shortness of breath, fatigue, vomiting, and pale-looking skin (“Acute Lymphocytic Leukemia” 2).
Multiple tests are conducted to diagnose a person with ALL. “Blood and bone marrow tests are done to look for leukemic cells” (“Acute Lymphocytic Leukemia” 3). Additionally, when a patient goes for regular check-ups at their oncologist’s office, a complete blood count is used to assist with the diagnosis (Hughes). Another test provided for diagnosis is a bone marrow aspirate. A bone marrow aspirate is performed “to take a closer look at the cells in the marrow in order to look for abnormal cells such as blast cells” (“Acute Lymphocytic Leukemia” 3). “Blast cells” is a term used to describe a type of blood cell disease caused by immature or undeveloped lymph cells (Hughes). Lastly, another test provided is a bone marrow biopsy. A bone marrow biopsy only gives information about how much disease is in the marrow (“Acute Lymphocytic Leukemia” 3).
When physicians are discussing possible treatments for a patient, they use information from tests to decide the type of drug therapy a patient needs and how long this potential treatment will last (“Acute Lymphocytic Leukemia” 3). When considering possible treatments, physicians need to consider the patient’s age and the number of ALL cells present in the blood (“Acute Lymphocytic Leukemia” 3). “If the ALL has spread to the covering of the brain or spinal cord,” physicians should take this into consideration while deciding the patient’s treatment (“Acute Lymphocytic Leukemia” 3). If patients have certain chromosomal alterations, physicians need to consider that when deciding treatment for a patient (“Acute Lymphocytic Leukemia” 3).
Numerous interventions are being used to handle acute lymphocytic leukemia (ALL). When a patient is diagnosed with ALL, they need to get down chemotherapy instantly (Hughes). Doctors use an intervention dubbed initiation therapy. Induction therapy’s intent is to promote blood cell counts to a normal degree (“Acute Lymphocytic Leukemia,” 3). With initiation therapy, a patient may have more than one drug per dose (“Acute Lymphocytic Leukemia,” 3). “Combining drugs can beef up the effect of the drugs” (“Acute Lymphocytic Leukemia,” 3). Chemotherapy can be given as an oral medication or by placing a catheter in the vein, usually the upper chest area (Hughes). Several ALL patients build up uric acid in their blood from their disease (“Acute Lymphocytic Leukemia,” 4). Uric acid is a chemical made in the body, and if a high amount of uric acid is present, painful kidney stones may happen (“Acute Lymphocytic Leukemia,” 4). Chemotherapy increases the risk of uric acid (“Acute Lymphocytic Leukemia,” 4).
Another form of possible intervention for patients with ALL is a spinal tap. A spinal tap is used to check the spinal fluid for leukemic cells (Hughes). Individuals with ALL have leukemic cells in the lining of the spinal cord and brain (Hughes). However, the cells may not always be found in the test of the spinal fluid (Hughes).
Allogeneic stem cell transplants are a rare intervention for ALL. “This intervention is used for only some patients with ALL” (“Acute Lymphocytic Leukemia,” 5). This is a good intervention for some higher-risk forms of ALL such as T-cell ALL, infant ALL, and adult ALL (Hughes). Allogeneic stem cell transplants are performed to give strong doses of chemotherapy or radiation therapy to kill the ALL cells, which will also kill the healthy stem cells in the marrow as well (“Acute Lymphocytic Leukemia,” 4). “The transplanted donor stem cells help start a new supply of red blood cells, white blood cells, and platelets” (“Acute Lymphocytic Leukemia,” 4).
This procedure is a very bad procedure (“Acute Lymphocytic Leukemia,” 4). Doctors normally encourage this procedure for adult ALL patients if they are not responding well to other interventions (“Acute Lymphocytic Leukemia,” 4). Although this is a dangerous procedure, the expected benefits exceed the potential risks (“Acute Lymphocytic Leukemia,” 4). An allogeneic stem cell transplant is not usually approved for a child unless the doctors have decided that the child’s type of ALL is not likely to respond well to chemotherapy (“Acute Lymphocytic Leukemia,” 4). Additionally, if the chemotherapy has not worked well, or if the child has relapsed ALL, then the doctors may consider this particular procedure (“Acute Lymphocytic Leukemia,” 4).
Post-initiation therapy is needed after a patient is in remission. Remission is when all of the marks of the disease are absent for an extended period of time (Hughes). This form of therapy is given in two- to three-year cycles (“Acute Lymphocytic Leukemia” 4). More often than not, ALL cells remain that are not found by common blood or marrow trials. Therefore, doctors provide the post-initiation therapy (“Acute Lymphocytic Leukemia” 4). However, the drugs used are not the same as the drugs used during initiation therapy (“Acute Lymphocytic Leukemia” 4). Doctors must consider a patient’s medical history to decide the best post-initiation therapy intervention for the patient. The first consideration is the patient’s response to initiation therapy (“Acute Lymphocytic Leukemia” 4). The last consideration the physicians must think about is whether the patient has certain chromosomal abnormalities (“Acute Lymphocytic Leukemia” 4).
The possible side effects of ALL vary from serious to minor. “The number of red cells may decrease, which is a common term called anemia” (“Acute Lymphocytic Leukemia” 5). ALL patients “may also have a drop in the number of platelets” (“Acute Lymphocytic Leukemia” 5). When a “platelet count is extremely low, he or she may need a platelet transfusion to prevent possible bleeding” (“Acute Lymphocytic Leukemia” 5). Some patients may notice a drop in white blood cells while fighting ALL (“Acute Lymphocytic Leukemia” 5). Since white blood cells fight off infections, a drop in white blood cells may result in an infection (“Acute Lymphocytic Leukemia” 5). “Such infections may be treated” with only the typical antibiotic (“Acute Lymphocytic Leukemia” 5). “To lower the risk of infection, a patient’s central line” must be kept clean (“Acute Lymphocytic Leukemia” 5).
Additionally, “a patient’s visitors and medical providers need to wash their hands well” (“Acute Lymphocytic Leukemia” 5). Mouth sores are also common in patients with ALL due to the chemotherapy (Hughes). To prevent getting mouth sores, the patient should maintain good oral hygiene (Hughes). More often than not, patients with ALL experience nausea and vomiting while receiving their chemotherapy treatment and even after their treatment (“Acute Lymphocytic Leukemia” 5). Doctors provide drugs to prevent nausea and vomiting (“Acute Lymphocytic Leukemia” 5). Additionally, diarrhea, hair loss, and rashes are also side effects of chemotherapy therapy (“Acute Lymphocytic Leukemia” 5).
Acute Lymphocytic Leukemia is the most common form of leukemia in children. ALL accounts for 80% of all childhood leukemias discovered today (Zieve 1). Children usually have a better outcome than the rare number of adult ALL patients (Zieve 1). “Without treatment, a person with ALL can expect to live for only about three months” (Zieve 1). ALL has many factors that are present throughout the entire process of ALL. Treatments vary from child to major interventions. Multiple tests are performed to help diagnose and treat ALL. In conclusion, ALL goes through six processes from the beginning of the disease to the end of the disease. Understanding ALL involves learning about its causes, symptoms, diagnosis, treatment, and the side effects.
