Overview
- Acute lymphoblastic leukaemia (ALL) is a rare type of cancer that affects the blood and bone marrow.
- It usually develops quickly and needs to be treated straight away.
- It's most common in children and young people, especially children aged 4 and under.
- How serious it is depends on the type of acute lymphoblastic leukaemia you have, your age and your general health.
Symptoms
Main symptoms of acute lymphoblastic leukaemia
Symptoms of acute lymphoblastic leukaemia (ALL) are not always obvious at first and can be similar to other conditions.
They usually appear quite quickly over a few weeks.
The main symptoms include:
- feeling tired or weak
- bleeding or bruising easily or for no reason
- looking more pale than usual
- getting ill a lot or taking longer than usual to recover from illnesses
- a high temperature
- swollen glands (usually in the neck, armpits and groin)
- pain in the bones or joints
- loss of appetite or losing weight without trying
- shortness of breath
- a swollen tummy – your tummy may feel painful, uncomfortable or full
Less common symptoms include:
- a headache
- being sick
- blurred vision
- fits (seizures)
- a cough
- a swollen and red face, neck, arms or hands – the redness may be harder to see on brown and black skin
- swollen veins in the neck or chest
See a GP if:
- you or your child have symptoms of acute lymphoblastic leukaemia
Ask for an urgent GP appointment or call 111 Wales if:
- your child is bleeding or bruising easily or for no reason
Call 999 or go to A&E if:
You or your child:
- have a swollen and red face, neck, arms or hands that came on suddenly – on brown and black skin the redness may be harder to see
- have swollen veins in the neck or chest that came on suddenly
Find your nearest A&E
Important
These symptoms are very common and can be caused by many different conditions.
Having them does not definitely mean you have acute lymphoblastic leukaemia. But it's important to get them checked.
This is because if they're caused by cancer, finding it early may mean it's easier to treat.
What happens at the GP appointment
The GP may check any parts of the body that are swollen or painful. They may listen to the chest to check if it sounds normal.
The GP may also arrange for an urgent blood test.
They may refer you for more tests or to see a specialist in hospital.
Sometimes you might have to go to hospital straight away.
Find out more
Causes
Who is more likely to get acute lymphoblastic leukaemia
Acute lymphoblastic leukaemia (ALL) is rare, but anyone can get it.
It's not always clear what causes it.
You might be more likely to get it if:
- you're a child or young adult – it's most common in children aged 4 and under
- you have a genetic condition such as Down's syndrome
- you've had certain types of chemotherapy treatment in the past
- you were exposed to a lot of radiation or had radiotherapy treatment in the past, especially when you were a child
- you are exposed to high levels of a chemical called benzene
- you have a weakened immune system, for example you have HIV
It's important to get any symptoms of acute lymphoblastic leukaemia checked by a GP.
Tests and next steps
Main tests for acute lymphoblastic leukaemia
If the GP refers you or your child to a specialist, you may need some tests to check for acute lymphoblastic leukaemia (ALL).
Tests may include:
- blood tests
- taking a small sample from the bone marrow using a needle (biopsy)
You may not have both of these tests.
If you have a bone marrow biopsy, you'll usually have a local anaesthetic, and you may be given medicine to help you relax (sedation). Young children may be given a general anaesthetic.
Getting your results
It can take a few weeks to get the results of your tests.
Try not to worry if your results are taking a long time to get to you. It does not definitely mean anything is wrong.
You can call the hospital or GP if you are worried. They should be able to update you.
A specialist will explain what the results mean and what will happen next.
If you're told you or your child have acute lymphoblastic leukaemia
Being told you or your child have acute lymphoblastic leukaemia can feel overwhelming. You may be feeling anxious about what will happen next.
A group of specialists will look after you throughout the diagnosis, treatment and beyond.
The team will include a clinical nurse specialist who will be your main point of contact during and after treatment.
You can ask them any questions you have.
Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.
They're there to listen if you have anything you want to talk about.
Call 0808 808 00 00.
Next steps
If you've been told you or your child have acute lymphoblastic leukaemia, more tests are usually needed.
Tests may include:
You may not have all of these tests.
The specialists will use the results of these tests and work with you to decide on the best treatment plan.
Find out more
Treatment
Main treatments for acute lymphoblastic leukaemia
Acute lymphoblastic leukaemia (ALL) is often treatable.
Treatment usually needs to start quickly.
The treatment will depend on:
- the type of acute lymphoblastic leukaemia you have
- your age
- your general health
It will usually include steroids and chemotherapy. It may also include targeted medicines, immunotherapy or a stem cell or bone marrow transplant.
Treatments to prevent and manage symptoms (called supportive treatments) will also be offered.
The specialist care team looking after you will:
- explain the treatments, benefits and side effects
- work with you to create a treatment plan
- help manage any side effects
You'll have regular check-ups during and after any treatments. You may also have tests and scans.
If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.
Steroids
Steroid medicine aims to get rid of the leukaemia cells.
You usually take them for up to a week before you start chemotherapy.
Find out more
Chemotherapy
Chemotherapy uses medicines to kill cancer cells.
It's the main treatment for acute lymphoblastic leukaemia.
You usually have a combination of chemotherapy medicines.
Find out more
Targeted medicines and immunotherapy
Targeted medicines aim to stop cancer growing.
Immunotherapy is where medicines are used to help the immune system kill cancer.
You may have targeted medicines or immunotherapy if:
- you have certain types of acute lymphoblastic leukaemia
- the cancer has come back
- other treatment is not working
Find out more
Stem cell or bone marrow transplant
A stem cell or bone marrow transplant replaces damaged blood cells with healthy ones.
You may have a stem cell or bone marrow transplant if the cancer has come back or it's likely to come back.
Find out more
Supportive treatments
You may need to have treatment to prevent or control symptoms caused by acute lymphoblastic leukaemia.
This may include:
- medicines such as antibiotics to prevent or treat infections
- blood transfusions
- medicines called growth factors to help the bone marrow make blood cells
- vaccines to help protect you from illnesses such as flu and COVID-19
Find out more
What happens if you've been told your cancer cannot be cured
Sometimes acute lymphoblastic leukaemia might be very hard to treat, and it may not be possible to cure the cancer.
If this is the case, the aim of treatment will be to limit the cancer and its symptoms, and help you live longer.
Finding out the cancer cannot be cured can be very hard news to take in.
You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.
They will work with you to help manage your symptoms and make you feel more comfortable.
The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.
Find out more
Help and Support
Where to find help and support
You and your loved ones will be supported throughout the treatment by a group of specialists.
The clinical nurse specialist, or another member of your specialist team will be able to give you information on local support services that you may find helpful.
There are also national cancer charities that offer support and information about acute lymphoblastic leukaemia (ALL).
Blood Cancer UK
Information and support for anyone affected by blood cancer.
Leukaemia Care
Information and support for anyone affected by leukaemia.
Children's Cancer and Leukaemia Group
Information and resources for parents and carers of children with cancer.
Macmillan Cancer Support
Information and support for anyone affected by cancer.
Cancer Research UK
Information and support for anyone affected by cancer.
Marie Curie
Care and support for anyone affected by a terminal illness.
The information on this page has been adapted by NHS Wales from original content supplied by 
NHS website nhs.uk
Last Updated:
05/09/2024 15:18:36