New Delhi: Acute Lymphocytic Leukemia (ALL) is a serious type of cancer that affects the blood and bone marrow. It moves very quickly, meaning it needs fast and strong treatment. In ALL, the body starts making too many abnormal, undeveloped white blood cells, which we can call “bad blood cells.” These bad cells quickly crowd out the healthy blood cells your body needs to function. While ALL can happen at any age, it’s the most common cancer in children, often appearing suddenly, which is why we call it a “rapid onset” disease.
In an interaction with News9Live, Dr. Nitin Sood, Vice Chairman, Medical Oncology, Bone Marrow Transplant, and Cancer Care, Medanta, Gurugram, spoke about ALL, its signs, diagnosis, and treatment options.
The Sudden Start and Common Warning Signs
When these bad blood cells multiply rapidly, they stop your body from making enough healthy red blood cells (which carry oxygen), platelets (which help blood clot), and good white blood cells (which fight infection). This shortage leads to a variety of symptoms that often send people to the doctor urgently. Patients might feel very tired, look pale, and get out of breath easily due to a lack of red blood cells (anemia). They might also get frequent infections and fevers because their immune system is weakened. Easy bruising, bleeding gums, or tiny red spots under the skin can signal low platelet counts. Swollen glands (lymph nodes), bone or joint pain, and an enlarged liver or spleen can also be signs, especially in kids.
Diagnosis: Pinpointing the Problem
Getting an ALL diagnosis usually happens quickly. It often starts with a standard blood test (called a CBC), which might show unusual levels of white blood cells, along with low red blood cells and platelets. To confirm the diagnosis, doctors perform a bone marrow biopsy. This involves taking a small sample of the spongy material inside your bones (bone marrow) to look for the abnormal blood cells. Special tests are then done on these cells to understand the specific type of ALL, which helps doctors choose the best treatment and predict how the disease might progress.
Older Treatments: The Power of Chemotherapy
For a long time, the main treatment for ALL has been strong anti-cancer drugs, known as chemotherapy. This treatment usually has several stages: an initial phase to destroy most cancer cells, followed by more treatment to kill any remaining cells, and then a longer phase to keep the cancer from coming back. For patients with a high risk of the cancer returning, or if it does come back, a stem cell transplant (also known as a bone marrow transplant) can be an option. This procedure essentially “resets” the blood-making system by replacing the diseased bone marrow with healthy blood-forming cells. While these treatments have greatly improved survival, they often come with significant side effects that can make patients feel very unwell.
Revolutionary Care: Smart Treatments and Immune Boosters
In recent years, the way we treat ALL has completely changed, bringing in what we call “smart treatments” and “immune boosters.” One of the most exciting breakthroughs is CAR T-cell therapy. This amazing treatment involves taking a patient’s own immune cells (called T-cells) and “reprogramming” them in the lab. These reprogrammed cells are then put back into the patient, where they act like “living medicine,” seeking out and destroying the cancer cells. This has offered incredible hope for patients whose cancer didn’t respond to other treatments.
Beyond CAR T-cells, other new treatments have emerged. There are “targeted drugs” that look for specific flaws in the cancer cells, like a faulty gene called the Philadelphia chromosome found in some ALL patients. These drugs can attack the cancer cells more precisely with fewer side effects. Another type of drug, called Bi-specific T-cell engagers (BiTEs), acts like a bridge, bringing the patient’s immune cells closer to the cancer cells so the immune system can attack them more effectively.
Hope for the Future
These revolutionary advancements have completely changed the outlook for ALL patients, especially those with hard-to-treat or returning cancer. While challenges still exist, our growing understanding of how ALL works at a detailed level, combined with our ability to boost the body’s natural defenses, offers incredible hope. Researchers are continually looking for new ways to fight the disease, make treatments even better, and find ways around resistance, bringing us closer to a future where ALL can be cured for everyone.
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