Acute lymphoblastic leukemia, called “ALL,” is a type of blood cancer. ALL is fast-growing and needs to be treated quickly. Blood is made up of different types of cells. These cells are made in the middle of the bones, in a part called the bone marrow.

People have ALL; their bone marrow makes abnormal blood cells instead of normal blood cells. These abnormal blood cells grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body. When the bone marrow makes abnormal blood cells, it does not make the normal blood cells a person’s body needs. This can cause symptoms.

Symptoms of ALL — The most common symptoms of ALL include:

• Feeling very tired and weak
• Bleeding more easily than normal
• Getting sick from infections more easily than normal

Test for ALL — the doctor or nurse will talk with people and do an exam. He or she will also do:

• Blood tests
• Bone marrow biopsy – A doctor will take a very small sample of the bone marrow. Then another doctor will look at the cells under a microscope to see if abnormal (cancer) cells are present.

 ALL treatment — Treatment for ALL is usually made up of 3 parts.

The first part of treatment is called “induction of remission” and lasts about 4 weeks. During this part, people stay in the hospital and get chemotherapy. Chemotherapy is the term doctors use to describe a group of medicines that kill cancer cells.

Most people are in “remission” after the chemotherapy. This means that doctors do not see any more abnormal blood cells in the blood or bone marrow. But even though doctors do not see any abnormal cells, there are still abnormal cells in the body. To kill these cells and prevent the ALL from returning, people need more treatment.

The second part of treatment is called “consolidation/intensification therapy” and lasts a few months. During this time, people can have 1 or more of the following treatments:

• More chemotherapy – People can go to the hospital during the day to get their chemotherapy, but do not always need to stay overnight.
• Radiation therapy – Radiation kills cancer cells.
• Bone marrow transplant – This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. These “donor” cells can come from different places, including:
• People who are related to you, and whose blood matches yours
• People who are not related to you, but whose blood matches yours
• Blood (that matches yours) from a newborn baby’s umbilical cord

The third part of treatment is called “maintenance therapy” and lasts 2 to 2 ½ years. During maintenance therapy, people get chemotherapy once a month. They also take other medicines (pills) on certain days of the month. Many people are able to return to their usual activities during this part of treatment.

After treatment — the doctor will check every so often to see if the cancer comes back. Regular follow-ups include talking with the doctor, exams, and blood tests. Sometimes, the doctor will also do a bone marrow biopsy.

ALL comes back — If the ALL comes back, people might have more chemotherapy, radiation, or bone marrow transplantation.

What else should I do? — It’s important to follow all the doctor’s instructions about visits and tests. It’s also important to talk to the doctor about any side effects or problems that have during treatment. Getting treated for ALL involves making many choices, such as what treatment to have and when.