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Thursday, August 5, 2021

08-05-2021-1042 - Acute lymphoblastic leukemia

 

Acute lymphoblastic leukemia
Other namesAcute lymphocytic leukemia, acute lymphoid leukemia
Acute leukemia-ALL.jpg
Bone marrow aspirate smear from a person with precursor B-cell ALL. The large purple cells are lymphoblasts.
SpecialtyHematologyoncology
SymptomsFeeling tired, pale color, fever, easy bleeding or bruising, bone pain, enlarged lymph nodes[1]
ComplicationsInfectiontumor lysis syndrome[2][3]
Usual onset2–5 years old[4]
TypesB-cell ALLT-cell ALL[2]
CausesUsually unknown[5]
Risk factorsIdentical twin with ALL, Down syndromeFanconi anemiaataxia telangiectasiaKlinefelter syndromehigh birth weight, significant radiationexposure[6][5][1]
Diagnostic methodBlood tests and bone marrow examination[3]
Differential diagnosisInfectious mononucleosisacute myeloid leukemialymphoblastic lymphomaaplastic anemia[3]
TreatmentChemotherapystem cell transplantationradiation therapytargeted therapy[7][1]
PrognosisChildren: 90% five-year survival rate[2]
Adults: 35% five-year survival[8]
Frequency1 in 1,750 children[4][9]
Deaths111,000 (2015)[10]

Acute lymphoblastic leukemia (ALL) is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes.[1] Symptoms may include feeling tired, pale skin color, fever, easy bleeding or bruising, enlarged lymph nodes, or bone pain.[1] As an acute leukemia, ALL progresses rapidly and is typically fatal within weeks or months if left untreated.[11]

In most cases, the cause is unknown.[2] Genetic risk factors may include Down syndromeLi-Fraumeni syndrome, or neurofibromatosis type 1.[1] Environmental risk factors may include significant radiation exposure or prior chemotherapy.[1]Evidence regarding electromagnetic fields or pesticides is unclear.[4][6] Some hypothesize that an abnormal immune response to a common infection may be a trigger.[4] The underlying mechanism involves multiple genetic mutations that results in rapid cell division.[2] The excessive immature lymphocytes in the bone marrow interfere with the production of new red blood cellswhite blood cells, and platelets.[1] Diagnosis is typically based on blood tests and bone marrow examination.[3]

ALL affected about 876,000 people globally in 2015 and resulted in about 111,000 deaths.[14][10] It occurs most commonly in children, particularly those between the ages of two and five.[15][4] In the United States it is the most common cause of cancer and death from cancer among children.[2] ALL is notable for being the first disseminated cancer to be cured.[16]Survival for children increased from under 10% in the 1960s to 90% in 2015.[2] Survival rates remain lower for babies (50%)[17] and adults (35%).[8] According to the National Cancer Intelligence Network (NCIN), generally for people with ALL: around 70 out of 100 people (70%) will survive their leukemia for 5 years or more after they are diagnosed.


https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia




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