Summary Acute Lymphocytic Leukemia (ALL) | Blood Cancer

Summary Acute Lymphocytic Leukemia (ALL)

Acute lmyphatic leukemia, or ALL for short, is an acute form of blood cancer characterized by an attack of malignant cells in the bone marrow. Every year, about 1.5 out of 100,000 people contract ALL, making it a rare disease. Nevertheless, ALL is the most common malignant disease in children.

In children under 4 years of age, the rate of illness per year is about 6.5 per 100,000 children. The symptoms are mainly caused by the fact that the healthy cells of the bone marrow are displaced by the malignant cells and are therefore no longer able to fulfil their task adequately. The lack of healthy white blood cells leads to a significantly increased susceptibility to infection.

Those affected therefore fall ill much more frequently with diseases such as pneumonia and the courses of the disease are sometimes life-threatening. The lack of red blood cells leads to anemia with pale skin, reduced performance and general weakness. A lack of platelets leads to bleeding signs, such as significantly increased occurrence of bruises, gum or nose bleeding and the appearance of small punctiform bleedings (petechiae), especially in the area of the lower legs.

Due to the displacement of the haematopoietic cells from the bone marrow, these cells have to do their work elsewhere. They migrate to the spleen and liver, which is why ALL often results in a significant enlargement of the liver and spleen (hepatosplenomegaly). Fever also occurs frequently, as does swelling of the lymph nodes.

Especially in children, the first symptom of ALL can be bone pain. The anamnesis is groundbreaking for the diagnosis. A blood test is also carried out.

However, this does not always have to show the typical findings with a significantly increased number of white blood cells, so that a bone marrow examination is necessary to confirm the diagnosis. The material obtained is then examined under a microscope and the diagnosis is made. Further special examinations such as immunophenotyping, imaging of the head if necessary, and spinal tap are performed. Therapy is then usually carried out with chemotherapeutic agents, often cortisone preparations are also used. In recent years, the prognosis of patients with ALL has improved significantly, but it is still a highly malignant disease that is often fatal.

Summary Chronic Myeloid Leukemia (CML)

Chronic myeloid leukaemia, or CML, is primarily an adult disease. Like the other forms of leukaemia, it is a rare disease with an annual incidence of just under 2 in 100,000 people. It accounts for about 20% of all leukaemias.

In most cases, the disease is caused by a genetic change in two chromosomes that exchange some of their genes with each other. This is called the Philadelphia chromosome. The change leads to a permanent activation of a certain enzyme and thus to unhindered growth of the affected cells.

Although it is a genetic mutation, the disease is not hereditary in the conventional sense, as the mutation only develops in the course of life. CML is divided into three stages: The chronic phase in which the affected person can remain asymptomatic for years, the acceleration phase and the blast crisis, which runs like acute leukaemia and leads to death if left untreated. The symptoms are rather mild.

CML in its chronic stage is often noticed during a routine examination. For example because of a significantly increased number of white blood cells in the blood or because of an enlarged spleen. In the acceleration phase, the typical symptoms of leukaemia such as fatigue, paleness and bleeding tendency increase.

In addition to the medical history and physical examination, a blood sample and a bone marrow examination are diagnostic tools. Therapeutically, the cytostatic drug hydroxycarbamide and, above all, a drug from the group of tyrosine kinase inhibitors can be used. Antibody therapy can also be used.

In order to achieve a complete cure, a stem cell transplantation can be considered. However, a stem cell transplantation is no guarantee for a cure.