1. Acute Lymphocytic Leukemia

2.  Leukemia is a type of cancer of the blood or
bone marrow characterized by an abnormal
increase of immature white blood cells
called "blasts". Leukemia is a broad term
covering a spectrum of diseases. In turn, it is
part of the even broader group of diseases
affecting the blood, bone marrow, and
lymphoid system, which are all known as
hematological neoplasms.

3.  In 2000, approximately 256,000 children
and adults around the world developed
some form of leukemia, and 209,000 died
from it. About 90% of all leukemias are
diagnosed in adults.
 Classification
 Clinically and pathologically, leukemia is
subdivided into a variety of large groups.
The first division is between its acute and
chronic forms:

4. Four major kinds of leukemia
Cell type Acute Chronic
Lymphocytic leukemia Acute lymphoblastic Chronic lymphocytic
(or "lymphoblastic") leukemia (ALL) leukemia (CLL)
Myelogenous leukemia Acute myelogenous Chronic myelogenous
(also "myeloid" or leukemia (AML) leukemia (CML)
"nonlymphocytic") (or myeloblastic)

5. Acute Lymphoblastic Leukemia
 Acute lymphoblastic leukemia (ALL) is a form of leukemia,
or cancer of the white blood cells characterized by excess
lymphoblasts.
 Malignant, immature white blood cells continuously
multiply and are overproduced in the bone marrow. ALL
causes damage and death by crowding out normal cells in
the bone marrow, and by spreading (infiltrating) to other
organs. ALL is most common in childhood with a peak
incidence at 2–5 years of age, and another peak in old age.
The overall cure rate in children is about 80%, and about
45%-60% of adults have long-term disease-free survival

6.  Acute refers to the relatively short time course of
the disease (being fatal in as little as a few weeks if
left untreated) to differentiate it from the very
different disease of chronic lymphocytic leukemia,
which has a potential time course of many years. It
is interchangeably referred to as Lymphocytic or
Lymphoblastic. This refers to the cells that are
involved, which if they were normal would be
referred to as lymphocytes but are seen in this
disease in a relatively immature (also termed
'blast') state.

7. Cases of Acute Lymphocytic
Leukemia are detected by:
Swelling in the abdomen
Enlarged lymph nodes
Bone or joint pain
Symptoms from an enlarged
thymus

8. Tests Used to Look for ALL
 Blood tests
 Bone marrow aspiration and biopsy
 Lumbar puncture (spinal tap)
 Lymph node biopsy

9. Lab Tests Used to Diagnose and
Classify ALL
 Blood cell counts and blood cell exam (peripheral
blood smear)
 Blood chemistry and coagulation tests
 Routine exams under a microscope
 Cytochemistry
 Flow cytometry and immunohistochemistry
 Cytogenetics
 Fluorescent in situ hybridization (FISH)
 Polymerase chain reaction (PCR)

10. Risk Factors for ALL
 Radiation exposure
 Certain chemical exposures
 Chemotherapy drugs
 Benzene
 Certain viral infections
 Infection with human T-cell lymphoma/leukemia virus-1
(HTLV-1)
 Epstein-Barr virus (EBV)

11.  Inherited syndromes
 Down syndrome
 Klinefelter syndrome
 Fanconi anemia
 Bloom syndrome
 Ataxia-telangiectasia
 Neurofibromatosis
 Race/ethnicity
 ALL is more common in whites than in
African Americans

12.  Gender
 ALL is slightly more common in males than in females.
 Having an identical twin with ALL
 Uncertain, unproven or controversial risk factors
 Exposure to electromagnetic fields (such as living near
power lines or using cell phones)
 Workplace exposure to diesel, gasoline, pesticides, and
certain other chemicals
 Smoking
 Exposure to hair dyes

13. Statistics/Prevalence
 Statistics on acute lymphocytic leukemia based on
rates from 2000 to 2002 indicate that 1 out of every 870
people born today will be diagnosed with ALL at some
point during their life. Other statistics show that the
median age at diagnosis was 11 years of age and the
median age at death was 47 years of age.
 The American Cancer Society estimated that 3,970
people (2,180 men and 1,790 women) would be
diagnosed with acute lymphocytic leukemia (acute
lymphoblastic leukemia, or ALL) in 2005.

14. From 1998 to 2002, the median age at diagnosis for acute
lymphocytic leukemia was 11 years. The percentages of
people diagnosed with ALL based on age are:
 63.6 percent were diagnosed under age 20
 9.7 percent between 20 and 34
 5.8 percent between 35 and 44
 6.1 percent between 45 and 54
 5.3 percent between 55 and 64
 4.5 percent between 65 and 74
 3.4 percent between 75 and 84
 1.5 percent 85+ years of age.

15. The age-adjusted acute lymphocytic leukemia incidence rate
was 1.5 per 100,000 men and women per year.
From 1998 to 2002, the median age at death from acute
lymphocytic leukemia was 47 years of age. The percentages of
people who died from ALL based on age are:
 22.2 percent died under age 20
 15.7 percent between 20 and 34
 9.6 percent between 35 and 44
 10.7 percent between 45 and 54
 11.1 percent between 55 and 64
 12.9 percent between 65 and 74
 12.4 percent between 75 and 84
 5.6 percent 85+ years of age.

16.  The age-adjusted acute lymphocytic leukemia
death rate was 0.5 per 100,000 men and women per
year in the United States.
 The five-year relative survival rates by race and sex
are:
 65.2 percent for Caucasian men
 66.7 percent for Caucasian women
 54.2 percent for African American men
 54.8 percent for African American women.