WHAT IS ACUTE LYMPHOBLASTIC LEUKAEMIA (ALL) IN CHILDREN

Acute lymphoblastic leukemia (ALL) happens when the body makes too many lymphoblasts (a type of white blood cell) and is counted  as the most common type of childhood cancer. It is called both the Acute Lymphocytic Leukaemia and Acute Lymphoid Leukaemia.

Different Kinds of lymphocytes (B-cells or T-cells).

• Doctors divide acute lymphoblastic leukemia into subtypes based on the type of lymphocytes involved. Most kids with ALL have a B-cell subtype.

• Acute lymphoblastic leukemia develops and worsens quickly. Prompt diagnosis is very important. With proper and timely treatment, most ALLs are cured.

Causes : Acute lymphoblastic leukaemia can happen in people of all ages, but kids between 2 to 5 are more vulnerable. Certain Risk factors for kids are: 

• Having an identical twin with the illness before age 6

• Being a fraternal twin and other sibling of a child with leukaemia

• Having an inherited genetic problem (such as Li-Fraumeni Syndrome or Down Syndrome)

• On medication  to suppress the immune system after an organ transplant

• Exposure to X-rays before birth

• Earlier radiation treatment or chemotherapy 

WHAT ARE SYMPTOMS OF  ACUTE LYMPHOBLASTIC LEUKAEMIA (ALL) IN CHILDREN

• tiredness, weakness or paleness

• swollen lymph nodes

• infections - bronchitis or tonsillitis

• fever

• night sweats

• easy bruising or petechiae (tiny red spots on the skin caused by easy bleeding)

• bone and joint pain

• belly pain (because cancerous blood cells build up in organs like the kidneys, liver, and spleen)

DIAGNOSIS & TREATMENT

Diagnosis: ALL in children can be diagnosed using the following modalities 

1. Blood Tests : Complete Blood Count, liver and kidney function panels, Blood chemistries checked under microscope.

2. Imaging Studies : X-ray, CT Scan, MRI, or Ultrasound to rule out other possible symptoms.

3. Bone marrow aspiration and biopsy of cells to figure out the type and subtype of the leukaemia to ascertain the line of treatment.

4. Genetic tests 

5. Lumbar Puncture (Spinal tap) to remove a small amount of cerebrospinal fluid (the fluid surrounding the brain and spinal cord) for lab examination. 

Treatment 

1. Chemotherapy

Doctors usually treat children diagnosed with acute lymphoblastic leukemia with chemotherapy  to kill cancer cells. How the cancer responds to the initial treatment is also important in choosing the type of chemo. Its goal is remission, which is when tests don't find any cancer cells in the body. Maintenance Chemotherapy for 2-3 years is later used to keep the child in remission and prevent the cancer from coming back. 

2. Stem Cell Transplants

• destroying cancer cells with high-dose chemotherapy and/or radiation

• putting healthy donor stem cells back into the body

• rebuilding a healthy blood supply and immune system with the new stem cells 

IMPORTANT INFORMATION

Prevention : In most cases, it can’t be controlled. Studies are checking into the possibility that some environmental things may put a child at risk for ALL e.g. Prenatal radiation exposure such as X-rays, may trigger ALL in an unborn baby.