Treatment of acute lymphoblastic leukemia abroad

Acute lymphoblastic leukemia is a malignant pathology of the hematopoietic system when tumour mass grows from the lymphoblasts (immature lymphoid cells).


It is the most common oncological disease among children between the ages of 1 to 6 years old. Leukemic cells spreads rapidly through the bloodstream, affecting the lymph nodes, spleen, bone marrow and central nervous system.


acute lymphoblastic leukemia


Causes of acute lymphoblastic leukemia

Main risk factors of acute lymphoblastic leukemia are:

  • Radiation
  • Exposure to toxins (benzene)
  • Viral infections (infectious mononucleosis, HTLV-1 virus)
  • Hereditary background
  • Congenital genetic and chromosome abnormalities including Down's syndrome


Other possible risk factors which influence the likelihood of developing acute lymphoblastic leukemia are:

  • Electromagnetic radiation
  • Smoking
  • Hair dye
  • Gasoline
  • Diesel fuel
  • Pesticides


Acute lymphoblastic leukemia more often develops among the representatives of European people. Boys get sick more often than girls. 


acute lymphoblastic leukemia causes


Symptoms of acute lymphoblastic leukemia

The hematopoietic system is greatly affected when acute lymphoblastic leukaemia is present. It results in a reduced number of all blood cells like platelets, leukocytes and erythrocytes.


This can lead to three syndromes:

  • Hemorrhagic which is an increased risk of bleeding, bruises on the body
  • anaemia which is distinguished by pale skin
  • shortness of breath, increased heart rate
  • immunodeficiency causes frequent respiratory infections, the occurrence of ulcers on the body and boils, fungal diseases


Most often patients having acute lymphoblastic leukemia complain about:

  • Tiredness
  • Weakness
  • Shortness of breath
  • Dizziness
  • Long duration of respiratory infections
  • Emergence of large bruising with minor injuries
  • Bleeding gums


General symptoms of intoxication appear. Patient loses weight. Night sweats, appetite loss, decreased body temperature is observed. 


acute lymphoblastic leukemia symptoms


Local symptoms that depend on the location of the tumour location:

  • Enlarged spleen, abdomen swelling
  • Enlarged lymph nodes (they are obvious and accessible to palpation only subcutaneous lymph nodes)
  • Pain in the bones and joints


Other clinical signs of the acute lymphoblastic leukemia depend on the illness prevalence and location:

  • If the brain is affected there can be numbness, seizures, vision disorders
  • if the chest organs are affected there can be shortness of breath, fluid accumulation in the pleural cavity
  • if the thymus is affected there can be cough, breathing problems, swelling of the face and neck (a consequence of compression of the superior vena cava)


acute lymphoblastic leukemia diagnostics


Diagnostics of acute lymphoblastic leukemia

Clinical blood count (CBC) leads to a reasonable suspicion of acute lymphoblastic leukemia. This is due to a decreased number of red blood cells, platelets and white blood cells as well as a change in leukocyte counts. Also too many immature white blood germ cells (lymphoblasts) are detected in the smear. 


Additional laboratory methods are:

  • Tests for coagulation
  • Blood chemistry


A diagnosis is confirmed only after the bone marrow biopsy. It is usually taken from the pelvic bones, sometimes from the chest. Specialists look at the number of blast cells in the biopsy specimen. Their norm is no more than 5%. When the illness is present, their number will grow up to 20-30% and more. 


Additional research methods that are used to detect the prevalence of the illness and to define its prognosis are:

  • Genetic tests
  • Lumbar puncture
  • Lymph nodes biopsy
  • Chest X-ray
  • Liver and spleen ultrasound
  • CT
  • MRI


acute lymphoblastic leukemia treatment abroad


Treatment of acute lymphoblastic leukemia abroad

Chemotherapy is the main form of acute lymphoblastic leukemia treatment. There are many types of treatments. Medicines and doses are chosen depending on the stage of the pathological process and a number of prognostic factors represented in the table below. 



First, they indicate the induction treatment. Its aim is to achieve remission. Remission considered being a reduction of blast cells in the bone marrow sample. Then consolidation stage follows. This is a drug therapy aimed at preserving prolonged remission. 


Some patients are treated with stem cells at the consolidation cells. Cells are harvested from the bone marrow or peripheral blood. These are then cultivated and are injected into to the patient. Transplantation can be autologous (patient’s own cells are used) or allogenic (donor’s stem cells are used). Allogenic transplantation is more effective as well as more dangerous for the patient. 


acute lymphoblastic leukemia latest treatment methods


Latest treatment methods of acute lymphoblastic leukemia

New methods of treatment are constantly being developed. They help to increase life expectancy of the patients who have acute lymphoblastic leukemia.


Among the latest medicinal achievements are:

  • Introduction of donor leukocytes. Allotransplantation promises to become even more effective in the near future. Research is conducted regarding the possibility of introducing the leukocytes received from the same donor who gave stem cells. This helps to strengthen the reaction “graft versus leukemia”.
  • Safe chemotherapy. A lot of adult patients, especially, elderly people, find it hard to tolerate chemotherapy. Hence the search for safer and better medication is ongoing. “Cloral” is one of the latest drugs that have already been approved for use among children. It will soon be good to go for the elderly patients’ treatment. 
  • Monoclonal antibodies. Artificially synthesised antibodies directed at the tumor cells are used for the treatment of acute lymphoblastic leukemia. Monoclonal antibodies react to the special protein cells that are located on the surface. Specialists are now researching a possibility of Alemtuzumab and Rituximab drugs for the treatment of this illness. 


acute lymphoblastic leukemia prognosis


Acute lymphoblastic leukemia - Prognosis

It is possible to reach remission among 80-90% of patients. Half of them will have recurrence sooner or later. General effectiveness of treatment is about 40%.  


Prognosis is much better for kids than for the adult patients. There is a general 5-year survival for 85% of children with acute lymphoblastic leukemia. 



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