Acute lymphocytic leukemia or acute lymphoblastic leukemia or acute lymphoid leukemia is a variety of blood cancer (leukemia) in which there is excessive production of malignant and immature white blood cell (lymphoblast). The disease is called acute as it progresses very fast.

This disease is considered to be the most common type of cancer occurring in children and with currently available treatment options the cure rate in children is about 80%. However acute lymphoblastic leukemia can also occur in adults with about 20 to 40% cure rate.

In this condition the spongy blood cell producing bone marrow is wasted in producing immature white blood cells. Hence production of other blood cells namely the red blood cells and the platelets are also decreased leading to number of symptoms. Common presenting symptoms include fever, increased susceptibility to number of infections namely pneumonia, increased risk of bleeding and anemia characterized by paleness, increased tiredness, increased heart rate and in severe cases heart failure.

Symptoms
Acute lymphoblastic leukemia usually presents with gum bleeding, pain in the bones, fever, frequent episodes of infections, nose bleeding, swollen glands all over the body mainly in the armpit, groin, neck areas, increased tiredness, loss of energy, pallor, difficulty in breathing, sudden unexplained weight loss, loss of appetite, appearance of tiny dot like bleeding spots just under the skin, swelling of the legs (pitting edema) etc.

Causes
Cancer occurs whenever there is abnormality in the cell division procedure leading to excessive and uncontrolled multiplication of abnormal cells. Another characteristic feature of cancer is spread of the malignant cells to different other organs of the body.

The cell division process is a highly controlled one and the number of cells in the body is controlled by the process of apoptosis, programmed cell death. By the process of apoptosis older cells are removed from the body. Like cell division apoptosis is also a highly controlled biological phenomenon. There are number of factors which can stimulate or suppress these two processes and thus maintain a balance between apoptosis and cell division. In cancer this balance is lost leading to uncontrolled excessive production of malignant cells due to uninhibited cell division and complete lack of apoptosis.

Changes in the regulatory factors occur due to sudden, unexpected and permanent change in the DNA, known as mutation.

The exact cause of mutation is not known however in acute lymphoblastic leukemia number of factors may be responsible for mutation of the concerned DNA. Common factors are genetic make up of a person, exposure to radiation etc. However doctors already established that most of the cases of acute lymphoblastic leukemia are not inherited.

In acute lymphoblastic leukemia not only there is excessive production of immature white blood cells leading deficiency of normal white blood cells but also inadequate production of other blood cells like the red blood cells and the platelets. Thus symptoms arise for inadequate production of all the blood cells; infection due to inadequate white blood cells, anemia occurs due to low red blood cell count and bleeding tendency increases due to fall in platelet count.

Risk factors
Common risk factors include past history of undergoing radiotherapy or chemotherapy for other cancer, exposure to excessive radiation as in survivors of nuclear explosion, having certain genetic diseases like Down’s syndrome, having a sibling suffering from the disease etc.

Treatment
Treatment of acute lymphocytic leukemia depends upon the phase of eth disease; the treatment options for different phases are

1. Induction therapy: the goal in this phase is to kill most of the cancerous cells in the bone marrow so that normal blood cell production is restored
2. Consolidation therapy: the goal in this phase is to kill the remaining cancerous cells after induction therapy
3. Maintenance therapy: the goal is to prevent growth of cancer cells in future

Treatment options include chemotherapy, targeted drug therapy, stem cell therapy and radiation therapy.