Adult ALL is rare. Most cases occur in children. There are different types of ALL, depending on:

• The cell of origin (B cell or T cell).

• The size and number of leukemia cells.

• The healthy cells most affected.

You are more likely to develop this condition if:

• You are male.

• You have a history of chemotherapy or radiation therapy.

• You have been exposed to high levels of radiation.

• You have certain genetic disorders, such as Down syndrome.

Symptoms of this condition include:

• Tiring easily, weakness, or shortness of breath.

• Point-shaped dark spots under the skin (petechiae), or easy bleeding from small cuts, nosebleeds, or bruising.

• Fever or repeat infections.

• Poor appetite or weight loss.

• Pain or bloating of the abdomen, bone pain or aches, or joint pain or aches.

• Testicular mass, swollen glands, or painless lumps in the neck, underarm, stomach, or groin.

• Pale skin or skin rash.

This condition may be diagnosed based on:

• Cell morphology.This involves blood tests to check blood cell counts and the shape of the blood cells.

• Aspiration and biopsy. These bone marrow tests check for leukemia cells.

• Genetic testing, which may be done to:

  • Determine the best outcome of the disease (prognosis).

  • Understand the risks you face from the disease (risk stratification).

  • Determine the best treatment options.

• Imaging tests, such as X-rays, ultrasound, and CT scan.

• A lumbar puncture, which tests a small amount of the fluid that surrounds the brain and spinal cord. The fluid is examined for leukemia cells.

Treatment for this condition depends on the type of ALL you have. Treatment can last for up to 2–3 years and aims to destroy leukemia cells and stop new diseased cells from growing. Treatment may include:

• Chemotherapy. These medicines kill cancer cells anywhere in the body.

• Radiation therapy. High-energy X-rays or gamma rays are used to kill cancer cells in a particular location in the body.

• Targeted chemotherapy to treat unwanted changes, or mutations, in genes, cells, or other components that make cancer cells grow. Targeted therapy:

  • May be used by itself or with chemotherapy.

  • Usually causes fewer side effects than chemotherapy.

• Stem cell transplant, which involves replacing diseased bone marrow with healthy bone marrow tissue from a donor.

• Participating in clinical trials to see if new, or experimental, treatments are effective.

• Immunotherapy. This uses medicines to help your immune system destroy cancer cells.

You may also be given:

• Antibiotic medicines to prevent lung infection (pneumonia).

• Other medicines to relieve treatment side effects.

• Donated blood (transfusions).

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.

• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

• Do not use dietary supplements or herbal medicines unless your health care provider tells you it is okay. Some supplements can make treatment less effective.

General instructions

• You and any visitors should frequently wash hands for at least 20 seconds, especially before and after meals, after being outside, and after using the toilet.

• Avoid contact sports or other rough activities. Ask your health care provider what activities are safe.

• Try to eat regular, healthy meals. Some treatments might affect your appetite.

• Keep all follow-up visits as told by your health care provider. This is important.