Adult acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated.
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
In ALL, too many stem cells become lymphoblasts, B lymphocytes, or T lymphocytes. These cells are also called leukemia cells. These leukemia cells are not able to fight infection very well. Also, as the number of leukemia cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia and easy bleeding. The cancer can also spread to the central nervous system (brain and spinal cord).
Signs & Symptoms
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 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
Treatment
There are several types of standard treatment. Your OHC doctor will help you determine the best care plan for you.
- Chimeric Antigen Receptor T-cell therapy (CAR-T) is one of the most exciting and promising cancer treatment breakthroughs in recent years. OHC is the first in Greater Cincinnati – and among the very few independent oncology groups in the U.S. – to bring this leading-edge therapy to our region for adults with aggressive blood cancers.
CAR-T Therapy is a type of immunotherapy that stimulates the body’s immune system to fight cancer.- Thousands of T-cells are extracted from the patient and reengineered in a lab to produce special receptors on their surface that fight and kill cancer cells.
- The reengineered cells are multiplied until there are millions and then infused back into the patient.
- The cells continue to then multiply on their own in the patient’s body. These cells will recognize and kill cancer cells and help guard against recurrence.
- Chemotherapy to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing
- Intrathecal chemotherapy may be used to treat adult ALL that has spread, or may spread, to the brain and spinal cord. When used to lessen the chance leukemia cells will spread to the brain and spinal cord, it is called central nervous system (CNS) sanctuary therapy or CNS prophylaxis.
- Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
- Stem cell transplant is a method of giving chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of a donor. After the chemotherapy is completed, the stem cells are given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.
- Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy and tyrosine kinase inhibitor therapy are types of targeted therapy used to treat adult ALL.
