Leukemia is a broad term for cancers of the blood cells. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15. Explore the links on this page to learn more about the types of leukemia plus treatment, statistics, research, and clinical trials.
NCI does not have PDQ evidence-based information about prevention of leukemia.
General Information About Adult Acute Lymphoblastic Leukemia
- Adult acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).
- Leukemia may affect red blood cells, white blood cells, and platelets.
- Previous chemotherapy and exposure to radiation may increase the risk of developing ALL.
- Signs and symptoms of adult ALL include fever, feeling tired, and easy bruising or bleeding.
- Tests that examine the blood and bone marrow are used to diagnose adult ALL.
- Certain factors affect prognosis (chance of recovery) and treatment options.
Leukemia may affect red blood cells, white blood cells, and platelets.
Normally, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell.
A myeloid stem cell becomes one of three types of mature blood cells:
- Red blood cells that carry oxygen and other substances to all tissues of the body.
- Platelets that form blood clots to stop bleeding.
- Granulocytes (white blood cells) that fight infection and disease.
A lymphoid stem cell becomes a lymphoblast cell and then one of three types of lymphocytes (white blood cells):
- B lymphocytes that make antibodies to help fight infection.
- T lymphocytes that help B lymphocytes make the antibodies that help fight infection.
- Natural killer cells that attack cancer cells and viruses.
Previous chemotherapy and exposure to radiation may increase the risk of developing ALL.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Possible risk factors for ALL include the following:
- Being male.
- Being white.
- Being older than 70.
- Past treatment with chemotherapy or radiation therapy.
- Being exposed to high levels of radiation in the environment (such as nuclear radiation).
- Having certain genetic disorders, such as Down syndrome.
Signs and symptoms of adult ALL include fever, feeling tired, and easy bruising or bleeding.
The early signs and symptoms of ALL may be like the flu or other common diseases. Check with your doctor if you have any of the following:
- Weakness or feeling tired.
- Fever or drenching night sweats.
- Easy bruising or bleeding.
- Petechiae (flat, pinpoint spots under the skin, caused by bleeding).
- Shortness of breath.
- Weight loss or loss of appetite.
- Pain in the bones or stomach.
- Pain or feeling of fullness below the ribs.
- Painless lumps in the neck, underarm, stomach, or groin.
- Having many infections.
These and other signs and symptoms may be caused by adult acute lymphoblastic leukemia or by other conditions.
Treatment Option Overview
- There are different types of treatment for patients with adult ALL.
- The treatment of adult ALL usually has two phases.
- Four types of standard treatment are used:
- Radiation therapy
- Chemotherapy with stem cell transplant
- Targeted therapy
- New types of treatment are being tested in clinical trials.
- Patients may want to think about taking part in a clinical trial.
- Patients can enter clinical trials before, during, or after starting their cancer treatment.
- Treatment for adult acute lymphoblastic leukemia may cause side effects.
- Follow-up tests may be needed.
There are different types of treatment for patients with adult ALL.
Different types of treatment are available for patients with adult acute lymphoblastic leukemia (ALL). Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
The treatment of adult ALL usually has two phases.
The treatment of adult ALL is done in phases:
- Remission induction therapy: This is the first phase of treatment. The goal is to kill the leukemia cells in the blood and bone marrow. This puts the leukemia into remission.
- Post-remission therapy: This is the second phase of treatment. It begins once the leukemia is in remission. The goal of post-remission therapy is to kill any remaining leukemia cells that may not be active but could begin to regrow and cause a relapse. This phase is also called remission continuation therapy.
Treatment called central nervous system (CNS) prophylaxis therapy is usually given during each phase of therapy. Because standard doses of chemotherapy may not reach leukemia cells in the CNS (brain and spinal cord), the leukemia cells are able to hide in the CNS. Systemic chemotherapy given in high doses, intrathecal chemotherapy, and radiation therapy to the brain are able to reach leukemia cells in the CNS. These treatments are given to kill the leukemia cells and lessen the chance the leukemia will recur (come back).