Acute lymphocytic leukemia (ALL) is also named acute lymphoblastic leukemia, which is the most common hematologic malignancy cancer of bone marrow. It is typically featured by the overproduction of immature lymphoblasts.
Acute lymphocytic leukemia (ALL) is a biologically heterogeneous disorder, so that the morphologic, immunologic, biochemical, cytogenetic, and molecular genetic characterizations of leukemic lymphoblasts are required to establish the diagnosis or to exclude other probable causes of bone marrow failure and, finally, to classify ALL subtypes. This heterogeneity demonstrates the actuality that leukaemia may establish at any point while on the several stages of normal lymphoid differentiation.
It has been reported that approximately 6000 patients are diagnosed with this condition annually, and it accounts for more than 75% of acute leukemias in children, and 20% of all leukemias in adults.
Chemotherapy (chemo) is the consideration of drugs to treat cancer. Chemo drugs are known to travel through the bloodstream to reach malignant cells all over the body. This makes chemotherapy useful for diseases such as leukemia that has spread throughout the body.
Chemotherapy is the main treatment for just about all individuals with acute lymphocytic leukemia (ALL). Due to its potential side effects, chemotherapy might not be recommended for patients in poor health, but advanced age by itself is not a barrier to getting chemotherapy.
How is chemotherapy given: Chemotherapy treatment for Acute Lymphocytic Leukemia is typically divided into 3 phases:
- Induction: It is short and intensive, typically lasts about a month.
- Consolidation (intensification): It is also intensive, typically lasting for a few months.
- Maintenance (post-consolidation): It is less intensive, typically lasts for about a couple of years.
During a bit more intensive phases of treatment, individuals can often have severe side effects from chemotherapy, so they might need to spend some time in the hospital.
Chemotherapy is typically given in cycles, with each period of treatment followed by a rest period to enable the body time to recover. Most often, chemotherapy drugs are injected into a vein (IV), into a muscle, or under the skin, or are taken orally. These drugs reach into the blood and can reach leukemia cells all over the body.
Most chemotherapy drugs have trouble reaching the portion around the brain and spinal cord, so the chemotherapy may need to be injected into the cerebrospinal fluid (CSF) to destroy malignant cells in that portion. This is named intrathecal chemotherapy. Intrathecal chemotherapy can be given during a spinal tap or by using a special catheter known as an Ommaya reservoir.
Chemotherapy Drugs Used to Treat ALL
Chemotherapy for acute lymphocytic leukemia uses a combination of anti-cancer medicines. The most commonly used chemotherapy drugs for leukemia (ALL) include:
Vincristine Liposomal: Vincristine liposomal specifically is a new form of a chemotherapy medicine named vincristine that may be a bit more effective and a bit less toxic than current chemotherapy drugs because it is encapsulated in a protective shell. It is administered straight into the bloodstream via a drip. Certain studies have suggested vincristine liposomal may be helpful for individuals whose first 2-treatments have already failed and their leukaemia has returned. It may also cause fewer adverse reactions than the current form of vincristine.
- First-line acute lymphoblastic leukemia (ALL)
- Acute lymphoblastic leukemia and hypersensitivity to native forms of L-asparaginase
Dexamethasone: It is another corticosteroid that acts as an crucial chemotherapeutic agent in treating ALL. Like prednisone, this medicinal product is used in induction and reinduction therapy and is also given as intermittent pulses while on continuation therapy.
- Hair loss
- Mouth sores
- Loss of appetite
- Increased probability of infections (from having too few normal WBCs)
- Bleeding bruising (from having decreased blood platelets)
- Fatigue and shortness of breath (from having too few RBCs)
- Cytarabine (Ara-C), mainly when used at high doses, can cause dryness in the eyes and can affect certain parts of the brain, which can lead to complications with coordination and balance.
- Vincristine can be responsible for damaging the nerves, which can lead to numbness, tingling, or weakness in hands or feet.
- Anthracyclines (such as daunorubicin or doxorubicin) can be responsible for damaging the heart, so the total dose requires to be watched closely, and these drugs might not be given to someone who already has heart complications.