BLOOD CANCER TREATMENT
Acute lymphoblastic leukaemia (ALL) is a type of blood cancer that starts from young white blood cells called lymphocytes in the bone marrow. Adults and children can get it but it is most often diagnosed in younger people.
There are two main types of acute leukaemia, myeloid and lymphoblastic. Lymphoblastic leukaemia can also be called lymphocytic leukaemia.
Acute lymphoblastic leukaemia (ALL) is divided into different groups (subtypes). Doctors use two different systems to work out which type a person has. These are the:
- World Health Organisation (WHO) system
- French and British (FAB) system
Ask your doctor which system they are using if you are unsure. The type of ALL you have tells you the type of cell that the cancer started in. Knowing this helps your doctor decide which treatment you need.
Finding the type of ALL
Your doctor looks at your leukaemia cells under a microscope to find out which group your leukaemia is in.
Your doctor also does tests for:
- proteins that some types of leukaemia cells make (immunophenotyping tests)
- chromosome changes in the leukaemia cells (cytogenetic tests)
World Health Organisation (WHO) system
Doctors mostly use the World Health Organisation (WHO) system. It's based on the type of lymphocyte (white blood cell) that has become cancerous and the characteristics the cell has. This system helps your doctors to plan treatment and predict how well the treatment will work. There are 3 different subtypes:
- pre (precursor) B cell ALL, this is the most common type in adults
- pre (precursor) T cell ALL, this is more likely to affect young adults and is more common in men
- mature B cell ALL, this type is identified by particular genetic changes
Mature B cell ALL is sometimes called Burkitt type ALL because it is similar to another cancer called Burkitt lymphoma.
Many symptoms of ALL are vague and non specific. You may feel as if you have flu. These symptoms are caused by too many abnormal white blood cells and not enough normal white cells, red cells and platelets.
Most people with one or more of these symptoms don't have leukaemia. But it's important to get any symptoms checked out by your GP.
General weakness
You might feel weaker than normal.
Feeling tired (fatigue)
You might feel more tired than normal, even if you're getting a good nights sleep.
High temperature (fever)
You might have a high temperature or feel feverish.
Frequent infections
You might pick up infections such as coughs and colds easily. Or you might find that the infections last a long time and are difficult to shake off.
This is because you don’t have enough healthy white blood cells to fight bacteria or viruses.
Bruising or bleeding easily
You might have:
- nosebleeds
- bleeding gums when you clean your teeth
- very heavy periods
- small dark red spots on your skin
- blood in your wee (urine) or poo (stool)
You might find you are bruising more easily than normal.
Weight loss
You might lose weight even if you haven't changed your diet.
Swollen lymph nodes
Your lymph nodes (glands) might feel swollen when you touch them. You have lymph nodes in lots of places in your body. They might feel swollen in:
- your neck
- under your armpit
- in your groin
Pain in your bones or joints
You might feel pain in your bones or joints. This might be a dull ache or more of a stabbing pain. It might be worse at different times of the day.
Too many abnormal white blood cells collecting in the bones, joints or lymph nodes may cause pain and swelling.
Feeling short of breath (breathlessness)
You might feel breathless when doing your normal day to day activities or from climbing a short flight of stairs. This could be because you do not have enough red blood cells.
Feeling full in your tummy (abdomen)
You might have a feeling of fullness or discomfort in your tummy (abdomen). This can happen if your liver or spleen are swollen.
Pale skin
You might look paler or more 'washed out' than normal.
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