The cancer that I am looking into!
Acute lymphocytic leukemia (ALL) is a fast-growing cancer of the blood and bone marrow that mainly affects white blood cells known as lymphocytes. Although it is rare overall (makes up less than 1% of all cancers in the United States), it is the most common cancer diagnosed in children, particularly those between the ages of two and five (makes up more than 75% of all childhood leukemia cases). While most cases occur in children, adults can also be diagnosed with ALL, especially those over the age of fifty. Doctors usually begin the diagnostic process with a CBC to check for abnormal white blood cells, followed by a bone marrow biopsy to confirm the presence of leukemia cells. Later they will use tests like flow cytometry and genetic testing to help determine the specific subtype and how aggressive the disease might be. Known risk factors include genetic conditions like Down syndrome, past exposure to high levels of radiation or chemotherapy, and certain inherited mutations although many cases appear without a clear cause. ALL is not staged in the same way as solid tumors. Instead of using the TNM system, doctors classify ALL based on whether the disease is newly diagnosed, in remission or has returned, and whether the cancer cells come from B-cell or T-cell lineages. Treatment is usually long and happens in several stages with patients often beginning with induction chemotherapy to quickly reduce cancer cells, then moving to consolidation therapy, and finally receiving maintenance therapy to keep the cancer from returning. Since ALL can spread to the central nervous system, many patients receive chemotherapy directly into their spinal fluid to help prevent that from happening. Some high-risk patients, especially those who do not respond well to standard treatment, may need a stem cell transplant. Newer treatments, such as targeted therapy with tyrosine kinase inhibitors and immunotherapies like CAR-T cell therapy, have also been helpful in treating difficult or relapsed cases. Researchers are also exploring gene-editing tools like CRISPR-Cas9, which may eventually be used to correct mutations in leukemia cells or enhance the ability of immune cells to target the cancer, although this technology is still in the early stages of development. The outcomes for people with ALL depends a lot on age and specificities of the disease. Children, especially those between ages one and nine who have more favorable genetic features, tend to do very well with over 90% surviving at least five years after their diagnosis. Adults, on the other hand, will often have more aggressive forms of the disease and lower survival rates (typically around 30-40%). Overall, the five-year survival rate for ALL in the U.S. is about 71-72%. Ongoing progress in treatments, better supportive care, and new discoveries in genetics and immunology continue to improve the chances of survival, especially for younger patients and those diagnosed early.
Sources:
- American Cancer Society. (2024). Key Statistics for Acute Lymphocytic Leukemia (ALL). https://www.cancer.org/cancer/acute-lymphocytic-leukemia/about/key-statistics.html
- National Cancer Institute. (2022). Adult Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version. https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq
- National Human Genome Research Institute. (2023). What are genome editing and CRISPR-Cas9? https://www.genome.gov/about-genomics/policy-issues/Genome-Editing/what-is-genome-editing ](https://pmc.ncbi.nlm.nih.gov/articles/PMC10733529/
- St. Jude Children’s Research Hospital. (2023). Acute Lymphoblastic Leukemia (ALL). https://together.stjude.org/en-us/conditions/cancers/acute-lymphoblastic-leukemia-all.html