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Acute Lymphoblastic Leukaemia (ALL)

Rapidly progressive lymphoid progenitor-cell cancer — curable with modern therapy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Acute Lymphoblastic Leukaemia (ALL)?

Acute lymphoblastic leukaemia (ALL) is a fast-moving leukaemia caused by clonal malignant transformation of B- or T-cell lymphoid progenitors. It accounts for around 12% of all leukaemias and 25% of childhood cancers, peaking between 2–5 years of age.

ALL is divided into B-ALL (85%) and T-ALL (15%) by immunophenotype. Philadelphia-chromosome-positive ALL (Ph+ ALL) occurs in 20–30% of adult ALL and prognosis has improved substantially with added TKIs (dasatinib, ponatinib). BCR–ABL1-like (Ph-like) ALL is an active area of research.

Paediatric cure rates now exceed 85–90%. Adult ALL is more challenging but immunotherapy agents such as blinatumomab and inotuzumab ozogamicin are significantly improving survival.

Symptoms

Rapid-onset fatigue and anaemia
Fever and recurrent infections (neutropenia)
Bleeding tendency: petechiae and epistaxis (thrombocytopenia)
Bone and joint pain
Lymphadenopathy
Hepatosplenomegaly
CNS involvement: headache and nausea (leptomeningeal leukaemia)

Risk Factors

Down syndrome (20–30-fold increased risk)
Li–Fraumeni and Bloom syndromes
Ionising radiation exposure
Prior chemotherapy
Genetic variants (IKZF1 deletion, Ph+ ALL, CRLF2 overexpression)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • In children, rapid-onset fatigue with fever and petechiae — urgent blood count and haematology
  • If blasts appear on the blood film — urgent haematology
  • Bone pain with anaemia in children — rule out malignancy
  • CNS symptoms (headache, ocular palsies) require CSF examination in suspected ALL

Treatment Methods

01
Induction: vincristine, prednisolone, anthracycline, asparaginase ± rituximab (CD20+ B-ALL)
02
Consolidation and maintenance: total 2–3 years of chemotherapy
03
Ph+ ALL: TKIs (dasatinib, ponatinib) added to chemotherapy
04
Blinatumomab: bispecific T-cell engager in MRD-positive or relapsed/refractory B-ALL
05
Inotuzumab ozogamicin: CD22 antibody–drug conjugate in relapsed/refractory B-ALL
06
Allogeneic stem cell transplant: consolidation for high-risk or relapsed ALL
07
CNS prophylaxis: intrathecal chemotherapy or craniospinal irradiation in selected cases

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.