WHAT IS ACUTE LYMPHOBLASTIC LEUKAEMIA (ALL) IN ADOLESCENT & YOUNG ADULTS 

Acute Lymphoblastic leukaemia (ALL) in the adolescent and young adult (AYA) population is a difficult clinical problem. Aged between 15 - 39 years, the AYA population draws a good deal of attention, particularly in the area of therapy selection

WHAT ARE SYMPTOMS OF ACUTE LYMPHOBLASTIC LEUKAEMIA (ALL) IN ADOLESCENT & YOUNG ADULTS

• Vague  constitutional complaints  

• looking paler than usual 

• feeling tired  (anaemia)

• you may bruise more easily and it could take longer for bleeding to stop

• infections 

• bone aches and pains 

• swollen glands (lymph nodes) in your neck, under arms or groin

• feeling unwell and run down

• fever and sweats 

• headaches and visual disturbances

There can be other reasons too for the above symptoms. You should see a specialist to determine the right course of treatment 

DIAGNOSIS AND TREATMENT 

Diagnosis: Can be made through the following means:

1. Blood tests help the doctors decide on the best treatment for you like immunophenotyping or flow cytometry

2. Bone marrow test - to count the numbers of leukaemia cells in the bone marrow. That may include sending for cytogenetic and immunophenotyping testing

3. Lumbar puncture - a small sample of the fluid that surrounds your brain and spinal cord 

4. Chest X-ray to see if there are any swollen lymph nodes (glands) 

Treatment 

1. Chemotherapy is the primary treatment for ALL. It may be given by mouth (orally), injected into a vein or muscle, or injected into the cerebral spinal fluid (CSF). Generally done in four phases:

2. Remission induction - Therapy uses chemotherapy to kill as many of the leukaemia cells as possible to cause the cancer to go into remission.

3. Central nervous system directed therapy kills any leukaemia cells in the central nervous system. Thus, preventing  the on spread of the disease to the spinal fluid.

4. Consolidation Therapy begins when the child’s leukaemia has gone into remission. Higher doses of chemotherapy, or drugs not used during previous treatment, are used to kill the majority of the remaining leukaemia cells.

5. Continuation or Maintenance Therapy lasts for two to three years to kill any remaining (residual) leukaemia cells.

6. Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. External Beam Radiation Therapy, is the commonest of the therapy given . Generally used only when the leukaemia has spread to the brain, spinal fluid, or a boy’s testicles, or in high-risk disease to help prevent the spread of leukaemia to the spinal fluid. 

7. Stem Cell Transplantation/Bone Marrow Transplantation may be recommended rarely as part of the initial therapy when leukaemia is associated with very high risk features.