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What Is Acute Lymphoblastic Leukaemia: Exploring Its Symptoms, Survival Rate, Life Expectancy, And Treatment

Cancer is a complex and often daunting diagnosis that can affect individuals of all ages, with various forms manifesting in different ways. Among these forms, certain types of leukaemia stand out due to their aggressive nature and the rapid progression of symptoms. One such type is Acute Lymphoblastic Leukemia (ALL), which is characterised by the uncontrolled proliferation of immature white blood cells known as lymphoblasts. 

This condition can disrupt normal blood cell production in the bone marrow and lead to serious health complications if not addressed promptly. To get more insights on the topic, we reached out to Dr Gopinathan M, Consultant Clinical Hematologist, MGM Cancer Institute, Chennai, to understand its symptoms, survival rates, life expectancy, and treatment options available to those affected.

What is Acute Lymphoblastic Leukaemia (ALL)?

Acute lymphoblastic leukaemia (ALL), also referred to as acute lymphocytic leukaemia, is a severe form of cancer that starts in the bone marrow, where blood cells are produced. This type of leukaemia primarily affects the body's white blood cells, particularly lymphocytes, which are crucial for immune function. According to Dr Gopinathan M, ALL is termed "acute" due to the rapid onset and progression of symptoms, which can develop within days to weeks.

The condition is most prevalent in children but can also occur in adults, affecting their overall health and quality of life. Early detection and treatment are vital for improving outcomes, as ALL can lead to serious complications if not addressed promptly. 

ALSO READ: Childhood Leukaemia: Types, Symptoms, and Treatment

Symptoms Of Acute Lymphoblastic Leukaemia (ALL)

Acute lymphoblastic leukaemia (ALL) presents with a range of symptoms that can vary in severity and duration. According to our expert, some of the key symptoms include the following. 

Prolonged Fever: A fever lasting more than two weeks, often without an apparent cause.

Fatigue: Continued tiredness that does not improve with rest.

Weight Loss: Unexplained loss of weight that may occur alongside changes in appetite.

Lymph Node Swellings: Small, swollen lymph nodes in areas such as the neck, armpits, and groin.

Abdominal Distention: A feeling of fullness or swelling in the abdomen.

Jaundice: Yellowing of the skin and eyes, indicating potential liver involvement.

Bone Pain: Particularly common in children, this can manifest as discomfort in the bones or joints.

What Is The Survival Rate and How Long a Person Can Live?

Dr Gopinathan M explains that the survival rate for acute lymphoblastic leukaemia (ALL) largely depends on the age at which the cancer is diagnosed. For children under 18 years old, survival rates are notably high, whereas adults diagnosed with ALL face different challenges due to the distinct genetic characteristics of adult leukaemia compared to pediatric cases. 

For children under 18 years old, survival rates are approximately 90% to 95% with standard chemotherapy treatments. 

Adults diagnosed with ALL generally have lower survival rates, ranging from 60% to 80%.

What is the life expectancy of individuals with Acute Lymphoblastic Leukaemia (ALL)?

The life expectancy of individuals diagnosed with acute lymphoblastic leukaemia (ALL) is influenced by several critical factors. Our expert shares that it includes genetic characteristics of the disease and the patient's response to treatment. Understanding these elements can provide insight into what patients might expect after diagnosis and treatment.

Genetic Background: The specific genetic markers associated with leukaemia can significantly impact prognosis and treatment outcomes.

Chemotherapy Tolerance: Patients who tolerate chemotherapy well and have favourable disease characteristics often experience a near-normal life after completing treatment.

Post-Treatment Recovery: While some patients may face limitations in daily activities due to treatment-related toxicities, many recover over months to years.

Survival Rates: The curative rates for ALL are approximately 80-85% in children, while adults have survival rates ranging from 60-80%.

Long-Term Outlook: With advancements in treatment, many individuals can achieve remission and lead fulfilling lives post-treatment, although ongoing monitoring is essential to detect any potential relapses.

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Is Acute Lymphoblastic Leukaemia (ALL) Curable?

Acute lymphoblastic leukaemia (ALL) is considered highly treatable, especially in children, where survival rates can reach up to 95% due to advancements in chemotherapy and targeted therapies. Detailing the cure, Dr Gopinathan M shares that in adults, survival rates range from 60% to 80%. Overall, with effective treatment, many patients can achieve remission and lead normal lives, highlighting the curative potential of ALL when managed properly.

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Acute Lymphoblastic Leukemia Specialists: Who To See

Hematologist-oncologists are doctors who specialize in treating blood cancers such as acute lymphoblastic leukemia (ALL).

ALL is a rare, rapidly progressing cancer of the blood and bone marrow. The bone marrow makes too many white blood cells, leading to extreme tiredness, high body temperature, and a tendency to bruise or bleed easily. ALL can spread to the brain and nervous system and tends to get worse quickly unless a person receives prompt treatment.

A specialist with experience in ALL can help to guide treatment, inform the individual, and set realistic expectations around the outlook and likely progress of treatment.

A doctor who specializes in treating ALL is known as a hematologist-oncologist. People who live in an area that does not have this type of specialist available can visit their nearest cancer specialist, who may be able to work with a hematologist-oncologist to map out the most effective treatment.

Hematologists are doctors who specialize in internal medicine, with a focus on treating diseases that affect blood. Oncologists specialize in treating cancers.

According to data from the Association of American Medical Colleges, as of 2021, almost 16,700 active physicians in the United States combine these disciplines as hematologists-oncologists.

In the United States, ALL is rare, accounting for less than 0.5% of all cancers, according to the American Cancer Society. As a result, people with ALL may wish to access a specialist experienced in this type of cancer.

Choosing an ALL specialist may start with picking a specific doctor or visiting a nearby facility. The decision process usually depends on an individual's location, knowledge of local facilities, and preference. Some people may rely on local services if they cannot travel out of their county or state.

A person's insurer might also have a specific network of approved doctors through which they will pay for all or some of a person's treatment. Individuals might also need a referral from a primary care physician before insurers will consider funding care.

People should speak to their provider or check their policy documents for their insurer's rules around provider networks and referrals.

Resources for finding a hematologist-oncologist

The following resources can help people find the ALL specialist who suits them:

Ask a primary care physician to recommend a hematologist-oncologist or appropriate facility in the area.

Get in touch with a local community cancer center.

Contact insurance or doctor referral services.

Phone a Leukemia and Lymphoma Society Information Specialist at 800-955-4572

Several online directories are available for help with finding appropriate board certified physicians, including:

The American Board of Medical Specialties (ABMS): The ABMS can help connect people with board certified specialists, including hematologist-oncologists.

The American Society of Hematology (ASH): The ASH offers a find a hematologist service that can help people with ALL match with appropriate hematologists in their local area.

Knowing what to ask or consider when meeting with a specialist can help a person choose the right doctor for them and understand their treatment plan better.

People should consider asking the specialist whether they are happy to have the session recorded. Alternatively, bring a laptop or notebook to take notes or have a friend or family member attend the session to take notes and provide emotional support where necessary.

Ask the hematologist-oncologist about the following to get a sense of their expertise and field of experience:

their board certification and licensing status

any professional societies to which they belong

their experience with treating ALL directly

the accreditation of their facility, and how often their facility treats people with ALL

the expected waiting time for appointments or callbacks

the availability of case managers, social workers, and nursing staff to support questions around quality of life

whether they recommend speaking to other hematologist-oncologists

when they are available for contact, and which queries an individual should instead refer to their family physician

the best way to contact them directly

how to access care out-of-hours

Be sure to ask a specialist about the results of any diagnostic treatments, what treatment options look like, and what the likely results of treatment will be.

Second opinions can help people to be sure about their diagnosis and feel more confident about the proposed treatment plan. People who do not need immediate treatment for aggressive leukemia and who have the following questions may wish to consider visiting another specialist for a second opinion:

Does their insurer require a second opinion before they will pay for treatment?

Is the individual confident that they have considered all of their options before committing to a treatment plan?

Does the individual have a rare leukemia subtype?

Does the person with leukemia feel that the doctor is underplaying the severity of the cancer?

Do they think other treatments may be available that their current doctor is not offering?

Does the individual's current hematologist-oncologist not specialize in their type of leukemia?

Has the doctor suggested more than one treatment option?

Are there barriers to understanding or communicating with their doctor?

Some people may wish to get a second opinion simply to verify their diagnosis and make sure they are choosing the right treatment plan.

People should contact their insurer to find out whether the policy covers second opinions. According to the Leukemia Research Foundation, most insurers pay for a second opinion on a leukemia diagnosis.

Leukemia resources

Visit our dedicated hub for more research-backed information and in-depth resources on leukemia.

How serious is acute lymphoblastic leukemia?

ALL progresses quickly without treatment. However, the outcome depends on the subtype of ALL, as well as the individual's age, where the cancer has spread, if the individual has certain gene changes, and whether the person is receiving first-time treatment for the ALL or the cancer has returned after a previous treatment.

Can you fully recover from acute lymphoblastic leukemia?

Most children with ALL recover fully, and remission times for adults have become much longer for adults over the last 30 years.

A hematologist-oncologist specializes in blood cancers such as acute lymphoblastic leukemia (ALL). A person seeking ALL treatment may be able to find one through physician recommendations or referrals, their insurer's network, the local cancer care community center, or the relevant medical association directories.

Upon connecting with a hematologist-oncologist, be sure to ask about their certifications, experience, expertise, and general patterns and expectations around communication. It might also help to get a second opinion to give you more confidence about the treatment plan or diagnosis.

Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is a form of leukemia, or cancer of the white blood cells characterized by excess lymphoblasts.

Malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow. ALL causes damage and death by crowding out normal cells in the bone marrow, and by spreading (infiltrating) to other organs. ALL is most common in childhood with a peak incidence at 2–5 years of age, and another peak in old age. The overall cure rate in children is about 80%, and about 45%-60% of adults have long-term disease-free survival.

Acute refers to the relatively short time course of the disease (being fatal in as little as a few weeks if left untreated) to differentiate it from the very different disease of chronic lymphocytic leukemia, which has a potential time course of many years. It is interchangeably referred to as Lymphocytic or Lymphoblastic. This refers to the cells that are involved, which if they were normal would be referred to as lymphocytes but are seen in this disease in a relatively immature (also termed 'blast') state.

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