Acute Lymphoblastic Leukemia (ALL)

Background of Acute Lymphoblastic Leukemia (ALL)

Acute lymphoblastic leukemia (ALL), also referred to as acute lymphocytic leukemia or acute lymphoid leukemia, is a type of cancer that starts in the inner part of the bones (bone marrow), but often moves quickly into the blood. In a healthy person, the bone marrow makes the blood stem cells that mature into infection-fighting white blood cells, oxygen-carrying red blood cells and blood-clotting platelets. When a person has ALL, the marrow makes too many immature white blood cells, called lymphoblasts. These lymphoblast white blood cells should turn into lymphocytes (mature white blood cells that help to protect the body from infections), but they do not. Too many lymphoblast cells grow in the marrow, which decreases the growth of red blood cells, other white blood cells and platelets. This causes anemia, bruising and frequent infections.

Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children in developed countries. About 5,200 people are diagnosed with ALL each year in the United States; about 20 percent of those new cases will be in adults. The lowest risk is for people between the ages of 25 and 50, and then increases after 50.

ALL is not inherited and it is not known what causes the disease. All types of leukemia can result from altered DNA in bone-marrow cells. Since exposure to high levels of external radiation — such as that experienced by people living near site of the Chernobyl power plant explosion — causes changes in bone-marrow DNA, radiation exposure may be a risk factor for ALL.

Hutchinson Center Acute Lymphoblastic Leukemia Research

Overview of Hutchinson Center ALL Research

The Hutchinson Center is recognized as one of the leading centers involved in the research and treatment for acute lymphoblastic leukemia (ALL). The center pioneered bone-marrow transplantation (BMT) and has trained doctors from around the world in bone-marrow and stem-cell transplantation. Today, transplantation remains one of the most effective treatments for most types of leukemia. Through clinical trials at the Seattle Cancer Care Alliance, ALL patients have access to the most promising treatments available.

Research topics

• Development of more effective transplant regimens with fewer toxic side effects, including the nonmyeloablative or "mini" transplant.
• Development of targeted therapies such as monoclonal antibodies used to deliver chemotherapy or radiation to cancer cells, sparing healthy cells from damage.
• Understanding the biology of blood and bone-marrow function, and the genetic origins of blood cancers like leukemia, which may shed new light on genes involved in acute lymphoblastic leukemia (ALL) progression and ultimately could lead to new drugs or other therapies that target defects in these genes.
• Discovering the delayed effects of the transplant preparative regimens and developing methods to treat these effects to minimize the toxicity on the patients. This is especially important for children who have to complete their physical growth and development after the transplant.

Recent accomplishments

• Pioneering the mini-transplant, a modified blood stem-cell transplant procedure that involves minimal total body irradiation and a stem-cell infusion; results in very few acute side effects, making the procedure much more tolerable for both younger and older patients; and often involves no hospitalization.
• Unprecedented disease-free survival rates of 76 percent for treatment of infants in first remission of acute lymphoblastic leukemia (ALL) — the most common cancer in this age group — using total-body irradiation followed by a bone-marrow transplant.
• Finding that bone-marrow transplantation between tissue-matched, unrelated individuals is a viable option for young children with ALL, the most common form of childhood cancer. For younger patients, this allows doctors to be more aggressive in terms of accepting patients for transplant rather than continuing to treat them with less effective chemotherapy.
• Detecting the earliest signs of relapse, or minimal residual disease, in a subset of ALL patients whose cancer cells contain a certain type of genetic defect. Using a highly sensitive test developed at the Hutchinson Center that can detect one in a million cancer cells, doctors can swiftly initiate new treatment in patients whose disease is recurring after initial therapy.

Articles Related to Acute Lymphoblastic Leukemia (ALL)

• Sanders gives ALL children hope — For 'Sanders' babies' with acute lymphoblastic leukemia, total-body radiation therapy followed by bone-marrow transplantation provides dramatic cure rates for infants
  
  
• Full recovery after cell transplantation for treating leukemia or lymphoma can take 3-5 years
  
  
• Transplants ALL the way — Procedure works to fight most common childhood cancer in cases without related donors, says study by Woolfrey
  
  

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