Acute Lymphoblastic Leukemia

  • Is a cancer of the bone marrow and blood

  • Progresses rapidly without treatment

  • Does not have a clear cause

What You Should Know

  • It's important to start treatment soon after diagnosis.

  • ALL is also called acute lymphocytic leukemia and acute lymphoid leukemia.

  • ALL affects the blood cells and immune system.

  • There are several ALL subtypes.

  • The type of treatment you receive and your treatment outcome depend on your ALL subtype and individual risk factors.

  • Most children with ALL are cured of their disease after treatment.

  • The numbers of adults and their remission lengths have grown significantly over the past 30 years.

Please click on the link below for an "easy read" on Leukemia provided by the

American Cancer Society

How Does ALL Develop?

ALL results from either an acquired or a genetic injury to the DNA (genetic material) of a developing stem cell in the bone marrow.

  • Stem cells form blood cells (white cells, red cells and platelets).

  • Although ALL starts in a stem cell in the bone marrow, it can spread to other areas such as the central nervous system, the lymph nodes and, more rarely, the testes.

This damaged cell becomes a leukemic cell and multiplies uncontrollably into billions of cells called leukemic lymphoblasts.

  • Leukemic lymphoblasts

    • Do not function normally

    • Block the production of normal cells

    • Grow and survive better than normal cells

As a result, the number of healthy blood cells (red cells, white cells and platelets) is usually lower than normal.

  • Anemia is a condition when there is a low number of red cells in the blood which can cause fatigue and shortness of breath.

  • Neutropenia is a condition when there is a low number of white cells so that the immune system can't effectively guard against infection due to a lack of neutrophils (a type of white cell).

  • Thrombocytopenia is a condition when there is a low number of platelets which can cause bleeding and easy bruising with no apparent cause.

  • Low numbers of all three blood cell counts is called pancytopenia.


Risk Factors

Doctors don't know why some cells become leukemic cells and others don't. For most people who have acute lymphoblastic leukemia (ALL), there are no obvious reasons why they developed the disease.

Risk factors associated with the disease include:

  • Exposure to high doses of radiation therapy (studied in survivors of atomic bomb detonations in Japan). A child exposed to multiple diagnostic x-rays may be at a slight increased risk of developing ALL, but further research is required to confirm these findings.

  • Previous exposure to chemotherapy and radiotherapy may cause ALL in adults.

  • Genetic disorders including: Down syndrome, neurofibromatosis, Klinefelter syndrome, Fanconi anemia, Schwachman syndrome, Bloom syndrome and ataxia telangiectasia have been associated with an increased risk of developing ALL.

  • Scientists continue to explore relationships between ALL and lifestyle or environmental factors. More developed countries and higher socioeconomic groups tend to have higher ALL rates.

  • Research supports the view that a number of complex factors are involved in the risk of developing ALL.

Currently, there's no way to prevent the disease. You can't catch ALL from someone else.


Prenatal Development

Some cases of ALL relate to a mutation in a lymphocyte that occurs during the prenatal period (in utero). The leukemia is usually diagnosed in infancy or the first few years after birth. However, years may pass before the disease appears. With ALL, it seems that additional genetic abnormalities can occur after birth and allow the unregulated cell growth that triggers the disease, because there are more mutations found in utero than there are cases of childhood ALL.


Source: Acute Lymphoblastic Leukemia. Reviewed by Elizabeth Raetz, MD.



There are 3 main phases of treatment for children with leukemia 

  • Induction

  • Consolidation (also called intensification)

  • Maintenance


Leukemia STATS


New Cases

  • In 2018, 60,300 people are expected to be diagnosed with leukemia.


  • There are an estimated 381,774 people living with or in remission from leukemia in the US.


  • The overall five-year relative survival rate for leukemia has more than quadrupled since 1960. From 1960 to 1963, the five-year relative survival rate among whites (only data available) with leukemia was 14 percent. From 1975 to 1977, the five-year relative survival rate for the total population with leukemia was 34.1 percent, and from 2007 to 2013, the overall relative survival rate was 63.7 percent.

  • From 2007 to 2013, the five-year relative survival rates overall were

    • CML - 68.0 percent*

    • CLL - 86.2 percent

    • AML - 27.4 percent overall and 66.4 percent for children and adolescents younger than 15 years

    • ALL - 71.0 percent overall, 91.8 percent for children and adolescents younger than 15 years, and 94 percent for children younger than 5 years.


  • In 2018, 24,370 people are expected to die from leukemia (14,270 males and 10,100 females).

  • In 2010 to 2014, leukemia was the sixth most common cause of cancer deaths in both men and women.

*The survival rate of CML in clinical trials is higher than the survival rate reported here, based on SEER data. It is speculated that close clinical monitoring
and better medication adherence in clinical trials are associated with a lower risk of disease progression and higher rates of survival.