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Health Corners
Cancers of the Blood

Acute Lymphocytic Leukaemia (ALL)

Lymphocytes are white blood cells that fight infection by making antibodies. These are found in the lymph system. The lymph system is a network of tubes filled with clear fluid called the lymph. When a person has Acute Lymphocytic Leukaemia, the lymphocytes are produced, but they do not mature fully and carry out their functions. More and more of lymphocytes are produced and this reduces the production of the red blood cells and platelets. This leads to anaemia, poor clotting and susceptibility to infection. The cancerous lymphocytes can also invade other organs, the spinal cord, and the brain.

ALL is the most common type of leukaemia in young children. This type of leukaemia may also affect adults, especially those aged 65 or more. This type of leukaemia progresses quickly.

  • Symptoms

  • Diagnostic Tests

  • Treatment Options
  • Symptoms

    The following are the most common symptoms for acute lymphocytes leukaemia,

    • Anaemia
    • Bleeding
    • Bruising
    • Fever
    • Persistent weakness
    • Tiredness
    • Aches in bones and joints
    • Swollen lymph nodes

    Investigations

    In addition to a complete medical history and physical examination, diagnostic procedures for acute lymphocytic leukaemia may include:

    • Blood tests
    • Bone marrow biopsy
    • Spinal tap

    Treatment:

    Treatment varies between patients who are to receive treatment for the first time and those who have been treated before. Treatment also depends on the stage to which the disease has progressed.

  • Chemotherapy is the primary treatment option.
  • Radiation therapy may be used in certain cases.
  • Bone marrow transplantation is an option under study.
  • Bone Marrow Transplantation

    Bone marrow transplantation is used to replace the patient's bone marrow with healthy bone marrow. First, all of the bone marrow in the body is destroyed with high doses of chemotherapy/ radiation therapy. Healthy marrow is then given to the patient through a needle in the vein.

    Marrow can be got from two sources.

    Allogeneic bone marrow transplant:

    In this type of transplant marrow is taken from another person (a donor) whose tissue matches the patient's. The donor may be a twin (the best match), a brother or sister, or another person not related.

    Autologous bone marrow transplant:

    In this type of bone marrow transplant, bone marrow is taken from the patient and treated with drugs to kill any cancer cells. The marrow is then frozen and preserved. The patient is given high-dose chemotherapy /radiation to destroy all of the remaining marrow. The frozen marrow is injected back into the patient. This kind of treatment is still under study.

    Phases of Treatment

    There are two phases of treatment for ALL. The first stage is called induction therapy. The purpose of induction therapy is to kill as many of the leukaemia cells as possible and control the progress of the disease.

    Once the patient shows no signs of leukaemia he or she enters a second phase of treatment called continuation therapy. This involves chemotherapy. Any remaining cells of leukaemia are killed. The patient may receive chemotherapy for several years to keep the disease in control..

    Radiation therapy or chemotherapy to the brain may be given to patients if leukaemia cells have spread to the brain. Another type of therapy, to prevent leukaemia cells from growing in the brain may also be given during induction therapy and remission.

    Of late bone marrow transplants are being done to replace the diseased bone marrow. First, all the bone marrow in the body is destroyed with high doses of chemotherapy with or without radiation therapy. Healthy marrow is then taken from another person (a donor) whose tissue is the same as or almost the same as the patient's.

    The effect of the treatment varies from patient to patient. The side effects may be difficult to cope with.

    Chronic Lymphocytic Leukemia

    Lymphocytes are white blood cells that fight infection by making antibodies. These are found in the lymph system. The lymph system is a network of tubes filled with clear fluid called the lymph. When a person has Leukaemia, the lymphocytes are produced, but they do not mature fully and carry out their functions.

    The lymphocytes may look normal, but they cannot fight infection as well as they should. These immature lymphocytes are then found in the blood and the bone marrow. They also collect in the lymph tissues and make them swell. Lymphocytes may crowd out other blood cells in the blood and bone marrow.

    A patient may develop anaemia. Bleeding and bruising may occur as there will not be enough platelets to help the blood clot.

    Chronic lymphocytic leukaemia progresses slowly and usually occurs in people 60 years of age or older.

  • Symptoms

  • Diagnostic Tests

  • Staging

  • Treatment Options
  • Symptoms

    The following are the most common symptoms for acute myelogenous leukaemia,

    • Anaemia
    • Bleeding
    • Bruising
    • Fever
    • Persistent weakness
    • Tiredness
    • Aches in bones and joints
    • Swollen lymph nodes
    • Loss of weight.

    Diagnosis

    Your doctor will ask for the following investigations to be made:

    • Blood Tests
    • Bone Marrow biopsy
    • Scans and X rays

    Staging:

    The spread of CLL is usually categorised in four phases.

    Stage 0

    There are too many lymphocytes in the blood, but there are usually no other symptoms of leukaemia.

    Stage I

    There are too many lymphocytes in the blood and lymph nodes are swollen.

    Stage II

    There are too many lymphocytes in the blood and lymph nodes and the liver and spleen are swollen.

    Stage III

    There are too many lymphocytes in the blood and there are too few red blood cells (anaemia). Lymph nodes and the liver or spleen may be swollen.

    Stage IV

    There are too many lymphocytes in the blood and too few platelets, which make it hard for the blood to clot. The lymph nodes, liver, or spleen may be swollen and there may be too few red blood cells (anaemia).

    Treatment:

    CLL patients need to be monitored as treatment may not be necessary at the time of diagnosis. There are treatments for all patients with chronic lymphocytic leukaemia. The following kinds of treatment are used:

    Chemotherapy

    Radiation therapy

    Surgery: This is not very common. A splenectomy may be performed, if your doctor feels that the spleen needs to be removed.

    Immuno Therapy

    Sometimes leukapheresis, or filtering of blood by a special machine to remove extra leukocytes, is performed.

    Alongside patients are also given treatment for complications of due to leukaemia such as infections, fever, bruises etc

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