Acute lymphoblastic leukaemia (ALL) 

Angela describes how she dealt with her two-year-old son's leukaemia diagnosis, and an expert explains the common symptoms and treatment options.

Find out more about leukaemia

Transcript of Acute lymphoblastic leukaemia (ALL)

Acute lymphoblastic leukaemia or ALL is a form of cancer of the blood.

It's derived from the lymphocyte producing cells in the bone marrow.

Acute leukaemia develops when these lymphocyte producing cells

for reasons we don't necessarily fully understand

stop maturing properly

and or also gain the ability to divide or proliferate more quickly.

This means that you have a build up

of these very immature lymphocytes or lymphoblasts within the bone marrow

and this means that the normal bone marrow cells are crowded out.

Well, when Josh was about two and a half,

he went back to crawling rather than walking.

He'd say his legs were too sore to walk

and he'd crawl around for the first half hour or so

and then start walking after that.

The main symptom was pains in his legs which would come and go.

He was also quite pale at that time.

Some of the symptoms are anaemia, so tiredness, short of breath, lethargy,

infections, high fevers, maybe mouth ulcers,

bleeding, bruising and rashes.

Most children will have enlargement of some lymph nodes

often round the neck or in the groin.

And often their liver and spleen may also be enlarged.

The other symptom which is quite common is bone pain

and this is one of the symptoms that actually is quite prominent

and often takes some time to diagnose.

The initial treatment while we're waiting to confirm that diagnosis

is mainly supportive, that might include fluids for hydration,

antibiotics if they've got an infection or fever,

maybe a blood transfusion or a platelet transfusion.

Chemotherapy is a general term that encompasses a lot of different drugs

and these can be given in tablet form,

or they may be given into the bloodstream directly,

or they may be given as muscle or subcutaneous injections.

And there are some drugs that are given into the central nervous system

via a lumbar puncture called intrathecal chemotherapy.

You get the nausea and just feeling tired and the hair loss obviously.

Joshua lost his hair three times,

that was each time the treatment was intensified.

It's a three-year course of treatment.

The first nine months is intensive treatment

and then the rest is maintenance therapy.

So in the first nine months he lost his hair three times,

once every three months or so.

The majority of children with ALL

will go into remission after their initial treatment,

and over 75-80% of those are cured, so we have a very good response rate.

A small proportion of children won't go into remission

and those children will probably require individualised care by their specialist,

and may require intense treatment for instance with a stem cell transplant.

It's sounds very daunting and very scary,

but once you realise you start to adjust and recognise what's going to happen

and become familiar with the treatment. You do feel a lot more at ease.

So it's not all as fraught as it is in the early days.

The things to bear in mind are this is a curable disease

and the majority of children will be cured.

Your primary treatment centre and your shared care centre

will do whatever they can

to enable the child's treatment to go as smoothly as possible

and to have a minimal disruption to the child and the family,

the brothers and sisters.


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