Acute Lymphocytic Leukaemia (ALL) Treatment in Delhi, India

Acute Lymphocytic Leukaemia (ALL), also known as acute lymphoblastic leukaemia, is a type of blood cancer that occurs when there is an immature formation of lymphocytes (a type of white blood cell). ALL develops in the bone marrow - a soft part of the bones where the blood cells are made. Acute lymphocytic leukaemia usually occurs in children and adults who are above 50 years of age.

The word 'acute' denotes that the disease has progressed rapidly and can become fatal within months. The word 'Lymphocytic' in ALL stands for the immature white blood cells called lymphoblasts. In some cases, ALL can also spread to other parts of the body, like the liver, spleen, spinal cord, brain, testicles, and lymph nodes.

Causes

In general, acute lymphocytic leukaemia occurs due to a mutation in the DNA of a cell developed in the bone marrow. However, it is still not clear what is the root cause for ALL. There is a lot of research going around to understand how some changes in the DNA in bone marrow cells can transform them into leukaemia cells.

For better understanding, the DNA inside makes up genes, which give instructions to the cell to function in a set manner. However, when there is a mutation - which can happen due to multiple reasons - the blood cell production goes out of control. This may result in the production of immature cells or lymphoblasts. These immature cells fail to function in the set manner and hamper the production of healthy cells.

Risk factors

Multiple factors can increase the risk of ALL. These include:

• Exposure to radiation.
• Genetic disorders.
• Exposure to chemicals such as benzene (found in cigarette smoke, detergents, paint strippers, and more).
• Having a medical condition related to genes like Down syndrome.
• Infection with human T-cell lymphoma virus-1 (HTLV-1) or Epstein-Barr virus (EBV).
• Being male.
• Smoking.

Symptoms

Acute Lymphoblastic Leukemia (ALL) symptoms may include:

• Fatigue
• Weakness
• Pale skin
• Frequent infections
• Fever
• Easy bruising or bleeding
• Petechiae (small red spots on the skin)
• Bone pain
• Joint pain
• Swollen lymph nodes
• Enlarged liver or spleen
• Headaches
• Vision changes
• Loss of appetite
• Weight loss
• Shortness of breath
• Night sweats
• Pain in the abdomen

Diagnosis

Your doctor might ask you about your family history and symptoms. They will perform certain physical exams to see if there is any sign of leukaemia. If your doctor suspects, he may ask you to do some tests, including:

• Blood Tests
• Bone Marrow Tests
• Imaging Tests
• Spinal Fluid Test

Treatments

Once your doctor diagnoses acute lymphocytic leukaemia, he will suggest certain phases of treatment. These treatments can be divided into four phases.

• First Phase (Induction Therapy): This is the first phase of the treatment in which certain drugs are given to kill most of the leukaemia cells in the blood and bone marrow
• Second Phase (Consolidation Therapy): This is the second phase, which is also known as post-remission therapy. In this phase, you will be given multiple cycles of intensive chemotherapy over six to nine months. The aim is to destroy the remaining leukaemia cells
• Third Phase (Maintenance Therapy): The third phase of the treatment is aimed at stopping the growth of leukaemia cells

Apart from this, there are other treatments for acute lymphocytic leukaemia. These may include:

Radiation Therapy: In this therapy, high-powered beams like X-rays or protons are used to kill the cancer cells. Radiation therapy is performed when the cancer cell has spread to the central nervous system.

Targeted Therapy: During targeted therapy, some targeted drugs are given to the patient that can target specific abnormalities present within the cancer cells. This therapy can be used in conjunction with chemotherapy to kill the leukaemia cells present in the body.

Chemotherapy: Chemotherapy is one of the most commonly used therapy in ALL. In this, chemotherapy drugs are given to kill the cancer cells.

Bone marrow transplant: It is a procedure that is used to remove cancerous bone marrow stem cells by donors' healthy stem cells. During this procedure, stem cells are removed from the blood or bone marrow of the patient or a donor. The stem cells are then frozen and stored. Once the chemotherapy is completed, stem cells are given back to the patient via an infusion technique. The stem cells then grow and restore the blood cells in the body.

Immunotherapy: In this method, certain drugs are given that will boost own immune cells to slow down the growth of cancer cells.

Clinical Trials: Clinical trials are studies of new drugs or treatments on people to test the feasibility of the new treatments or methods. Clinical trials can provide state-of-the-art cancer treatment. However, it is important to note that these treatments have a fair share of benefits and risk factors. Therefore, it is important to discuss all the aspects with your doctor.

Prevention

It is not clear what causes the mutations in the DNA, and therefore there is no known way to prevent it. However, one can take some precautionary measures like avoiding cancer-causing chemicals (benzene), smoking, usage of tobacco, and more.

Survival rate

Complete remission is achieved in approximately 90 per cent of the patients, with almost 40 per cent of them enjoying long-term survival rates. However, about 5 per cent of patients die during some treatment-related complications during the initial phase of therapy.