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When Your Child Has Acute Lymphoblastic Leukemia (ALL)

Teen girl having infusion treatment.Your child has been diagnosed with acute lymphoblastic leukemia (ALL). It is a common type of childhood cancer that is usually curable with treatment. ALL is also called acute lymphocytic leukemia. Your child’s healthcare team will help you as you make important decisions about your child’s health. Read on to learn more about ALL and how it is treated.

What is ALL?

ALL is a fast-growing cancer that affects blood and bone marrow (the spongy space inside of bones where new blood cells are made) and blood. The blood is made up of 3 main types of cells:

  • White blood cells fight infection.

  • Red blood cells carry oxygen throughout the body, which gives a person energy.

  • Platelets help the blood to clot, which helps stop bleeding when a person is cut.

ALL affects the white blood cells. When a person is healthy, white blood cells form in the bone marrow. With ALL, large numbers of abnormal white blood cells called leukemic blasts are produced. Leukemic blasts crowd out healthy cells. As time goes on, there are more blasts than healthy cells, so that the blood can’t do its job. This leads to problems, such as infections and bleeding. Anemia can also occur. This is a condition in which the blood doesn’t have enough red blood cells.

Who gets ALL?

ALL is the most common type of childhood cancer. It is most common in children between the ages of 2 and 4, although it can occur at any age. ALL is not contagious, meaning your child can’t pass it to another person.

What causes ALL?

ALL occurs when a certain type of white blood cell called lymphocytes grows abnormally. What causes this to happen is not fully known. In rare cases, factors, such as certain inherited conditions or exposure to certain chemicals might play a role. But most often, the cause of leukemia in children is unknown.

What are the symptoms of ALL?

Some common symptoms of ALL include fever, infections, easy bruising or bleeding, pale skin, tiredness, weakness, bone pain and weight loss. Your child may have experienced some of these symptoms, or other symptoms.

How is ALL diagnosed?

Your child’s healthcare provider examines your child. You will be asked about your child’s health history. Your child may also have one or more of the following:

  • Blood tests to take samples of blood and examine them under a microscope

  • Imaging tests, such as a chest X-ray, to take detailed images of areas inside the body

  • Bone marrow aspiration and biopsy to take a sample of bone marrow from the hipbone

  • Lumbar puncture, also called spinal tap, to take a sample of the fluid that surrounds the spinal cord from the child’s lower back

How is ALL treated?

Chemotherapy (“chemo”) is the main treatment used for ALL. It destroys cancer cells with powerful cancer-fighting medicines. Treatment is a combination of chemo medicines. They may be given by mouth, injection, or through a tube (IV) that’s usually put into a vein in the arm or chest. Your child’s healthcare provider can tell you more. For some children who are at higher risk for their leukemia coming back, high-dose chemotherapy may be given along with a stem cell transplant. In certain instances, other treatments such as radiation therapy may be used. 

Supportive treatments

The goal of supportive treatments is to protect the child from infection, prevent discomfort, and bring the body’s blood counts to a healthy range. During your child’s treatment, he or she may be given antibiotics. These help prevent and fight infection. Anti-nausea and other medicines may also be given. These help ease side effects caused by chemotherapy. Your child may receive blood product transfusions to restore the blood cells destroyed by treatment. Blood is taken from a donor and stored until the child is ready to receive it.

What are the long-term concerns?

With treatment, ALL is usually curable. But chemotherapy and radiation therapy may cause some problems, such as damage to certain organs. So your child’s health will need to be monitored for life. This may include clinic visits, blood tests, and other folow-up monitoring.

Call the healthcare provider

Contact the healthcare provider right away if your child has signs of infection, including any of the following:

  • A temperature of 100.4°F (38.0°C) or higher

  • A fever that lasts more than 24-hours

  • Your child has had a seizure caused by the fever

  • Chills

  • Cough

  • Pain that can’t be controlled

  • Uncontrolled nausea or vomiting

  • Weakness

  • Diarrhea

Coping

Receiving a cancer diagnosis for your child is scary and confusing. It’s important to remember that you are not alone. Your child’s healthcare team will work with you and your child throughout your child’s illness and care. You may also wish to seek information and support for yourself. Doing so can help you cope with the changes cancer brings. Learning about and talking with others who also have a child with cancer may help you and your family cope. Some helpful resources include:

  • Leukemia Research Foundation
    www.leukemia-research.org

  • The Children’s Leukemia Research Association
    www.childrensleukemia.org

  • The Leukemia & Lymphoma Society
    www.lls.org

 

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