Acute lymphoblastic leukemia

This page was reviewed under our medical and editorial policy by

Tibor Kovacsovics, MD, Hematologic Oncologist, City of Hope | Phoenix

This page was updated on August 11, 2023.

Acute lymphoblastic leukemia (ALL), also called acute lymphocytic leukemia or acute lymphoid leukemia, is a blood cancer that results when abnormal white blood cells (leukemia cells) derived from lymphoid precursors (partially differentiated cells) accumulate in the bone marrow.

There are two types of lymphoid cells: B-cells and T-cells. ALL is typically associated with B-cells. B-cells and T-cells play active roles in preventing the body from infections and germs and destroying cells that have already become infected. B-cells particularly help prevent germs from infecting the body while T-cells destroy the infected cells.

Who gets acute lymphoblastic leukemia?

ALL can occur at any age, but acute lymphoblastic leukemia occurs most frequently in people under the age of 15 or over the age of 45. ALL makes up the largest percentage of leukemia diagnoses in children under the age of 15 (specifically between the ages of two and four). It is less common for adults to develop this disease, but the rate increases at the age of 45.

Acute lymphoblastic leukemia symptoms

ALL progresses rapidly, replacing healthy cells that produce functional lymphocytes with leukemia cells that can't mature properly. The leukemia cells are carried by the bloodstream to other organs and tissues, including the brain, liver, lymph nodes and testes, where they continue to grow and divide. The growing, dividing and spreading of these leukemia cells may result in a number of possible symptoms.

ALL symptoms are often similar to those of the flu and may include:

  • Fever
  • Weakness
  • Fatigue
  • Headaches
  • Loss of appetite
  • Pale skin
  • Vomiting
  • Body aches

Other potential signs and symptoms of ALL may include:

  • Bleeding gums
  • Frequent infections
  • Nosebleeds
  • Easy bruising
  • Swollen lymph nodes around the neck, underarm, stomach or groin
  • Shortness of breath
  • Weight loss

Acute lymphoblastic leukemia treatment

Treatment for ALL is complex and may include chemotherapy,  immunotherapy and/or chemotherapy followed by stem cell transplantation and radiation therapy. The patient's integrated team of leukemia experts will answer his or her questions and recommend treatment options based on his or her unique diagnosis and needs. Options may include clinical trials, if available.

The initial treatment for ALL begins with induction chemotherapy, in which a complex combination of drugs is used to destroy as many leukemia cells as possible and bring blood counts to normal. This is followed by the consolidation phase, using either chemotherapy, immunotherapy or bone marrow transplant.

Patients with ALL may also receive maintenance chemotherapy. This less intensive course of chemotherapy is used to reduce the risk of the disease recurring after the inclusive treatment phase has finished.

Acute lymphoblastic leukemia survival rate

The National Cancer Institute SEER Program reports that the five-year relative survival rate for patients with ALL is 71.3 percent. The number is highest in children and drops with older age.


This means that 71.3 percent of people with acute lymphoblastic leukemia are alive five years or more after diagnosis, compared to people who don’t have ALL.


Next topic: What is acute myeloid leukemia?

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