Acute Lymphoblastic Leukemia (ALL)

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Acute Lymphoblastic Leukemia (ALL): Fast Facts

• Acute lymphoblastic leukemia—also referred to as acute lymphocytic leukemia or acute lymphoid leukemia—is a type of blood cancer that starts in the inner part of the bones, known as bone marrow, but often moves quickly into the blood. There are many different subtypes of ALL.
• In a healthy person, bone marrow makes 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, which never turn into mature white blood cells. When too many lymphoblasts grow in the marrow, the growth of red blood cells, other white blood cells and platelets decreases, leading to anemia, bruising and frequent infections.
• ALL is the most common type of cancer in children in developed countries. People between the ages of 25 and 50 face the lowest risk of getting the disease, but risk increases again after age 50.

Read more about leukemia treatment at the Seattle Cancer Care Alliance. »

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Acute Lymphoblastic Leukemia (ALL): Some of Our Key Research

The Hutchinson Center is recognized worldwide as one of the leading centers involved in research and treatment of acute lymphoblastic leukemia (ALL). Center researchers pioneered bone-marrow transplantation and have trained doctors from around the world in this treatment. Thanks to a variety of clinical trials at the Seattle Cancer Care Alliance, of which the Hutchinson Center is a key collaborator, ALL patients have access to the most promising treatments available.

The SCCA's transplantation record continues to receive top marks. It is one of only two transplant programs nationwide that consistently outperformed the expected one-year survival rate for unrelated donor transplants, according to an independent report that assessed 122 transplant centers over a five-year period beginning in 2002. Learn more. »

Pioneering bone-marrow transplantation
One of the Hutchinson Center's founders, Dr. E. Donnall Thomas, won the Nobel Prize in 1990 for his groundbreaking work in bone-marrow transplantation, one of the greatest success stories in cancer treatment.

Since then, Center investigators have trained physicians around the world in this procedure, and many new advances have occurred.

Read more about the Hutchinson Center's transplantation work. »

Boosting cure rates for infants with ALL
Dr. Jean Sanders, a longtime specialist in children's cancers, reported achieving an unprecedented 76 percent disease-free survival rate after treating infants with ALL in first remission by using total-body irradiation, followed by a bone-marrow transplant.

Before Sanders' study, doctors had generally shunned radiation for babies as producing devastating effects on the child's long-term health, but Sanders said the babies proved resilient in many ways. For instance, contrary to the popular medical opinion that total-body irradiation causes learning problems in children, Sanders and colleagues found no long-term impact from the ALL treatment on the child's learning abilities. Learn more. »

Listen to a Webcast with Dr. Jean Sanders. »

Improving treatment for children with ALL
Research by Dr. Ann Woolfrey and colleagues has shown that children with ALL can successfully receive bone-marrow transplants from tissue-matched but unrelated donors. The study, whose results were most encouraging in younger children, indicated that doctors can be more aggressive in recommending bone-marrow transplants for children with ALL who don't have a tissue-matched relative to donate bone marrow. Learn more. »

Understanding side effects of ALL treatment
A large study published by Hutchinson Center researchers found that survivors of childhood ALL have an increased chance of being significantly shorter in height as adults, as compared with their siblings. Although that effect may be largely cosmetic, researchers are also working to understand how the long-term effects of cancer treatments like chemotherapy and radiation can affect one's risk for obesity, early death from cardiovascular disease, and developing a second cancer. Learn more. »

Investigating new sources of transplantation cells
About one-third of all blood-cancer patients whose best curative treatment option is bone-marrow transplantation are unable to find a tissue-matched donor. One alternative is receiving a transplant that uses umbilical cord blood, which is rich in blood stem cells and can be collected without risk from the umbilical cord after birth of a child.

A major advantage of this source of cells for bone-marrow transplantation is that it does not need to be as well tissue-matched, allowing those patients who can not find a conventional donor to undergo transplantation. The major disadvantage is the small number of cells available from the cord blood.

Dr. Colleen Delaney and researchers in Dr. Irwin Bernstein's lab are investigating the effectiveness of transplantation using cord blood cells that have been cultured in the lab in order to increase the number of cells available for transplant. Their goal is to make cord-blood transplantation safer and more effective. Learn more. »

Listen to a Webcast with Dr. Colleen Delaney. »

Fortifying the body against leukemia
Dr. Stanley Riddell and colleagues have been investigating use of a treatment technique for leukemia called immunotherapy—that is, harnessing the body's own infection-fighting T-cells against the disease. T-cells, however, typically die quickly, resulting in an interruption in immune response that could cause cancer to return. Through advanced testing, Riddell and colleagues found that one type of T-cell—central memory cells—had the staying power they were seeking. The approach holds promise for treating several types of cancer, including chemotherapy-resistant ALL in children. Learn more. »

Measuring quality of life after transplantation

• Many patients who undergo bone-marrow or stem-cell transplantation face a decline in mental skill and physical coordination after treatment, but a 2004 study by Dr. Karen Syrjala and colleagues has shown that these effects are largely temporary and that most patients can expect a return to normal function within a year of their transplant. A more recent analysis showed that most patients show even further improvement in brain function between one and five years after transplant. Learn more. »

• Another study led by Syrjala found that survivors of stem-cell transplantation for blood cancers can expect to be just about as healthy 10 years later as adults who have never had a transplant. The study found that transplant survivors and people who hadn’t had transplants reported similar rates of hospitalization and outpatient medical visits. They also had similar rates of diseases and conditions such as asthma, diabetes, high blood pressure, high cholesterol, osteoporosis and hypothyroidism, along with similar psychological health, marital satisfaction and employment. It is, however, very important for transplant survivors to get regular primary care and health monitoring in the years after transplant. Learn more. »

Listen to a Webcast with Dr. Karen Syrjala. »

Find out more about our ALL investigators:
Fred Appelbaum » William Bensinger » Irwin Bernstein » Anthony Blau » Paul Carpenter » Elihu Estey » Matthew Fero » John Hansen » Kenneth Kopecky » Paul Martin »	John Pagel » Stephen Petersdorf » Oliver Press » Jerry Radich » Jean Sanders » Andrei Shustov » Karen Syrjala » Roland Walter » Edus "Hootie" Warren » Ann Woolfrey »

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Acute Lymphoblastic Leukemia (ALL): More Resources

• Every advance in cancer treatment in recent years has come out of clinical trials that test innovative medical approaches on patients.Find out more about clinical trials on acute lymphoblastic leukemia. »

• The Hutchinson Center also conducts ongoing cancer-prevention studies that depend on participation of healthy volunteers. Learn more about getting involved in research studies. » 

• In need of medical attention for leukemia? Visit the Seattle Cancer Care Alliance to get help. »

• The Hutchinson Center is on a mission to eliminate cancer and related diseases as causes of human suffering and death, and you can help. Make a gift today. »

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