National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Acute lymphoblastic leukemia


Other Names:
ALL; Acute lymphocytic leukemia
Categories:
Subtypes:
Acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).[1] It may develop in children or adults. ALL spreads to the blood fairly quickly, and then may spread to other areas of the body such as the lymph nodes, liver, spleen, central nervous system, and testicles (in males).[2] Signs and symptoms of ALL may include fever, easy bruising or bleeding, feeling tired, loss of appetite, pain in the bones or abdomen, and painless lumps in the neck, underarm, stomach, or groin.[1][3]

ALL is typically caused by random, non-inherited changes in the DNA of immature lymphocytes called lymphoblasts.[2][4] However, some people may inherit a genetic susceptibility to developing ALL.[4] The risk to develop ALL may also be increased by past treatment for cancer, and by having certain genetic conditions or syndromes. Having one or more risk factors does not mean that a person definitely will develop ALL.[1]

Treatment of ALL depends on the person's age, how advanced the cancer is, and whether certain genetic changes are found in cancer cells. Treatment options may involve systemic and/or intrathecal chemotherapy, radiation therapy, targeted therapy, and/or a stem cell transplant.[1][3] Biologic therapy and chimeric antigen receptor (CAR) T-cell therapy are currently being studied as treatment options and may be used when other therapies are not working.[1][3]

The chance of recovery also depends on many factors.[1][3] With treatment, about 98% of children with ALL go into remission, and 85% of those with first-time ALL are expected have no long-term complications.[5] The chance of recovery for adults is not as high, as 20-40% of adults are cured with current treatments.[6]
Last updated: 10/31/2017

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
Percent of people who have these symptoms is not available through HPO
Acute lymphoblastic leukemia 0006721
Polygenic inheritance 0010982
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Last updated: 7/1/2020

Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources

  • The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.

FDA-Approved Treatments

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products.

  • Nelarabine (Brand name: Arranon®) - Manufactured by GlaxoSmithKline
    FDA-approved indication: Treatment of patients with T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma whose disease has not responded to or has relapsed following treatment with at least two chemotherapy regimens
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information
  • Inotuzumab ozogamicin (Brand name: Besponsa) - Manufactured by Pfizer, Inc.
    FDA-approved indication: Treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).
    National Library of Medicine Drug Information Portal
  • Blinatumomab (Brand name: Blincyto) - Manufactured by Amgen, Inc.
    FDA-approved indication: March 2018 approval for the treatment of B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease (MRD) greater than or equal to 0.1% in adults and children. Previously approved in December 2014 for treatment of Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information
  • Clofarabine (Brand name: Clolar®) - Manufactured by Genzyme Corporation
    FDA-approved indication: Treatment of pediatric patients 1 to 21 years old with relapsed or refractory acute lymphoblastic leukemia after at least two prior regimens
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information
  • Buffered intrathecal electrolyte/dextrose injection (Brand name: Elliotts B Solution) - Manufactured by QOL Medical, LLC
    FDA-approved indication: For the intrathecal administration of methotrexate and cytarabine for the prevention or treatment of meningeal leukemia and lymphocytic lymphoma.
    National Library of Medicine Drug Information Portal
  • Erwinia L-Asparaginase (Brand name: Erwinase) - Manufactured by EUSA Pharma, Inc.
    FDA-approved indication: Treatment of patients with acute lymphoblastic leukemia (ALL) who have developed hypersensitivity to E. Coli-derived asparaginase.
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information
  • Imatinib mesylate (Brand name: Gleevec®)
    FDA-approved indication: Treatment of adult patients with relapsed or refractory Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ALL)
    National Library of Medicine Drug Information Portal
  • Ponatinib (Brand name: Iclusig) - Manufactured by ARIAD Pharmaceuticals Inc.
    FDA-approved indication: Treatment of adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ALL) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy.
    National Library of Medicine Drug Information Portal
  • Vincristine sulfate liposome injection (Brand name: Marqibo) - Manufactured by Talon Therapeutics, Inc.
    FDA-approved indication: Treatment of adult patients with Philadelphia chromosome-negative (Ph-) acute lymphoblastic leukemia (ALL) in second or greater relapse or whose disease has progressed following two or more anti-leukemia therapies.
    National Library of Medicine Drug Information Portal
  • Pegaspargase (Brand name: Oncaspar®) - Manufactured by Enzon, Inc.
    FDA-approved indication: Combination chemotherapy for the treatment of patients with acute lymphoblastic leukemia who are hypersensitive to native forms of L-asparaginase.
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information
  • mercaptopurine oral solution (Brand name: Purixan) - Manufactured by Nova Laboratories Limited
    FDA-approved indication: Treatment of patients with acute lymphoblastic leukemia as part of a combination regimen.
    National Library of Medicine Drug Information Portal
  • Dasatinib (Brand name: Sprycel) - Manufactured by Bristol-Myers Squibb Company
    FDA-approved indication: December 2018, dasatinib (Sprycel) was approved for the treatment of pediatric patients 1 year of age and older with Ph+ CML in chronic phase and newly diagnosed Ph+ ALL in combination with chemotherapy. Previously in June 2013, it was approved for treatment of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia with resistance or intolerance to prior therapy.
    National Library of Medicine Drug Information Portal
    Medline Plus Health Information
  • Methotrexate oral solution (Brand name: Xatmep) - Manufactured by Silvergate Pharmaceuticals, Inc.
    FDA-approved indication: April 2017, methotrexate oral solution (Xatmep) was approved for the treatment of pediatric patients with acute lymphoblastic leukemia (ALL) as a component of a combination chemotherapy maintenance regimen.
    National Library of Medicine Drug Information Portal

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Acute lymphoblastic leukemia. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Organizations Providing General Support

Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Financial Resources

  • Good Days provides help to patients with life-altering conditions. Assistance includes help with the cost of medications and travel.
  • Patient Access Network Foundation (PAN Foundation) has Assistance Programs for those with health insurance who reside in the United States. The disease fund status can change over time, so you may need to check back if funds are not currently available. 
  • The Social Security Administration has included this condition in their Compassionate Allowances Initiative. This initiative speeds up the processing of disability claims for applicants with certain medical conditions that cause severe disability. More information about Compassionate Allowances and applying for Social Security disability is available online.

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version. National Cancer Institute. October 26, 2017; https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq.
  2. What is Acute Lymphocytic Leukemia?. American Cancer Society. December 2, 2014; https://www.cancer.org/cancer/acute-lymphocytic-leukemia/about/what-is-all.html.
  3. Adult Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version. National Cancer Institute. October 26, 2017; https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq.
  4. Hamosh A. Leukemia, acute lymphoblastic; ALL. Online Mendelian Inheritance in Man (OMIM). August 9, 2017; https://www.omim.org/entry/613065.
  5. Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)–Health Professional Version. National Cancer Institute. September 28, 2017; https://www.cancer.gov/types/leukemia/hp/child-all-treatment-pdq.
  6. Seiter K. Acute Lymphoblastic Leukemia (ALL). Medscape Reference. September 2, 2017; https://emedicine.medscape.com/article/207631-overview.