Acute Lymphoblastic Leukemia

With various types of leukemia being discovered, Acute Lymphoblastic Leukemia or ALL in short has been found to be an aggressive type of leukemia. ALL occurs when there is a mutation in the production of lymphocytes in the bone marrow. With this mutation, the complication can be seen initially in the lymph nodes, to the spleen, liver and the central nervous system. Aside from being an aggressive type of leukemia, it can also metastasize in a rapid rate.

ALL can happen the all age groups. When diagnosed early in childhood, the chances of survival with treatment is good however, when it is adult onset, the prognosis can be lesser.

Signs and Symptoms:

  1. Easy fatigability
  2. Fever
  3. Night sweats
  4. Signs of bleeding such as bruises, bleeding gums and petechiae
  5. Sudden loss of weight
  6. Lack of appetite
  7. Bone pain or joint pain
  8. Lymph nodes swelling (neck, armpit, groin)
  9. Abdominal discomfort

Diagnostic Measures:

  1. Blood work such as complete blood count with differential count is the initial step in screening.
  2. Blood chemistry work up that includes serum uric acid, creatinine, blood urea nitrogen, potassium, phosphate, calcium, bilirubin levels.
  3. A clotting test is also taken in order to check for occurrence of disseminated intravascular coagulation.
  4. 4. Bone marrow biopsy and aspiration is done oncologists or haematologists in order to monitor the effect of ALL on the bone marrow.


The future health state of individuals with ALL depends on the how early the illness was diagnosed. According to the research, patients who were diagnosed between one to 25 years old have better chances of survival.

When ALL is diagnosed late especially in adults, there are central nervous system involvement which may also affect survival rate of the individual. Other chromosomal abnormalities also report a poor prognosis. Early detection is the only key in helping ALL patients survive.

Medical Treatment:

A combination of chemotherapeutic agents is given in effort to lower the lymphocytes in the bone marrow. The course of treatment is found to be grouped into three phases. Each phase has a unique purpose and works well when followed properly.

Remission phase is the first part of the treatment wherein the lymphocytes are controlled. The next step is to protect the central nervous system for complications or metastasis. Central Nervous System Prophylaxis is done systematically. The last phase involves post remission wherein the blood is being monitored closely for regrowth of unwanted lymphocytes.

There are times that ALL will recur despite the aggressive intervention. Plans regarding such situation have also been devised through clinical studies. Practically, there would another introduction of chemotherapy which is usually followed by bone marrow transplantation. The bone marrow transplantation is executed using the individual’s own bone marrow cells.

When there is recurrence, the purpose of treatment goes into the part of eliminating the signs and symptoms only but not the disease. This palliative attention is done as the second part of treatment.

Presently, the treatment of ALL is still on the process of revision as more and more information has been added about this disease. Researchers are now taking into attention about autologous transplantation or latest chemotherapeutic products as a possible option in treating ALL.

Image by:

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

What Do You Think?