Acute lymphocytic leukemia (ALL) is a fast-growing cancer in which the body produces a large number of immature white blood cells (lymphocytes). These cells can be found in the blood, bone marrow, lymph nodes, spleen, and other organs.

ALL makes up 80% of childhood acute leukemias. Most cases occur in children between ages 3 and 7. The disease may also occur in adults.

In acute leukemia, cancerous cells multiply quickly and replace normal cells. Cancerous cells take over normal parts of bone marrow, causing bone marrow failure. A person with ALL is more likely to bleed and have infections because there are fewer normal blood cells.

Most cases of ALL have no obvious cause. However, chromosome problems, radiation, toxins such as benzene, and some chemotherapy drugs may play a role in the development of leukemia.

Persons with Down syndrome or who have a brother or sister with leukemia have an increased risk for ALL.

• Bleeding gums
• Bone pain or tenderness
• Easy bruising
• Excessive or prolonged bleeding
• Fatigue
• Fever
• Joint pain
• Infection
• Menstrual irregularities
• Nosebleeds
• Paleness
• Palpitations
• Pinpoint red spots on the skin
• Shortness of breath (made worse by exercise)
• Swollen glands (lymphadenopathy)
• Swollen gums
• Unintentional weight loss

A physical exam may reveal the following:

• Bruising
• Enlarged liver and spleen
• Signs of bleeding (petechiae, purpura)

Blood tests may show the following:

• Abnormal WBC count
• Anemia on a CBC
• Low platelet count

A bone marrow aspiration may be show abnormal levels of certain cells.

ALL may also change the results of the following tests:

• T-lymphocyte count
• B-cell leukemia/lymphoma panel
• White blood cell differential

If you are diagnosed with ALL, genetic tests will be done to determine the specific type of ALL. Doctors can look for chromosome changes in the cells of some leukemias. Leukemias with certain types of chromosome changes have a poor outlook, while those with other types of genes can have a very good outlook.