Children's Health Children's Diseases and Conditions

Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is the most common cancer in children. It is a blood cancer that affects the infection fighting cells of the body known as white blood cells. Approximately 1,600 new cases are diagnosed annually in the United States. Through the tireless endeavors of cooperative study groups, the current cure rate of Acute Lymphoblastic Leukemia (ALL) is 80%. In this article, I will discuss the causes, symptoms, treatment, disease recurrence, long-term complications, and future directives of childhood ALL.

Causes of Acute Lymphoblastic Leukemia
In most children the cause of ALL has remained elusive despite intense research efforts. Current clinical wisdom points towards a viral cause. In fact, some oncologists (cancer specialists) believe that viral exposure while the child is still in the mother's uterus sets the stage for leukemia formation. This philosophy is reinforced by the finding of identical leukemia markers at diagnosis and from newborn screening blood samples. Further work is needed in this important area of investigation.

Children with certain genetic (or chromosome) disorders (Down Syndrome, ataxia-telangiectasia, etc.) and/or immune system problems (x-linked severe combined immune deficiency, Wiskott-Aldrich syndrome, etc.) are at an increased risk of developing ALL. In some of these rare disorders the underlying mechanisms resulting in cancer are being unraveled.

Symptoms
Children with ALL usually get bone marrow failure. The bone marrow produces the various cells in the blood. The symptoms that a child with ALL experiences are primarily due to the dramatic decrease in the numbers of these blood cells. Anemia (decreased activity and appetite, pale appearance), easy bruising, bleeding from the nose and gums, infections and mouth ulcers may all occur. Other signs and symptoms include fever, back pain, bone pain, the inability to walk, enlarged neck glands, enlarged testicles, headaches and rarely, metabolic (sodium and potassium) imbalances.

Diagnosis
These clinical findings prompt the pediatrician to perform a blood test called a complete blood count. If his or her suspicion is confirmed (by low blood counts), the next step is to refer the child to a pediatric cancer specialist.

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