Acute Lymphoblastic Leukemia (ALL)

Expert Care and Treatment for Leukemia and Related Disorders

Dana-Farber Brigham Cancer Center’s Adult Leukemia Program within the Hematologic Oncology Treatment Center includes hematologists, medical oncologists, pathologists, and radiation therapists who specialize in treating patients with all types of leukemia and related blood and bone marrow disorders.

Your care team will collaborate to develop a comprehensive, personalized treatment plan that offers the most advanced therapies and an array of supportive resources.

Adult Leukemia Program

Dana-Farber Brigham Cancer Center’s Adult Leukemia Program within the Hematologic Oncology Treatment Center includes hematologists, medical oncologists, pathologists, and radiation therapists who specialize in treating patients with all types of leukemia and related blood and bone marrow disorders.

Your care team will collaborate to develop a comprehensive, personalized treatment plan that offers the most advanced therapies and an array of supportive resources.

Adult Leukemia Program

What Is Acute Lymphoblastic Leukemia?

Acute lymphoblastic leukemia (ALL) is a blood cancer in which the bone marrow produces too many immature lymphocytes (a type of white blood cell), called lymphoblasts. This kind of cancer is called "acute" because it is usually a fast-growing kind of leukemia. ALL is caused by genetic changes in the cancer cells. These can be structural changes in chromosomes or in specific genes. It is not clear what causes these abnormalities to happen in any specific person. Most cases of ALL are not inherited.

Incidence

Acute lymphoblastic leukemia is a very rare disease that can develop at any age. Approximately half of cases are diagnosed in children younger than 20 years old. The other half of cases are diagnosed in adults. Only about 2,500 new cases are diagnosed in adults each year in the United States. Clinicians at Dana-Farber Brigham Cancer Center have expertise caring for patients with this rare leukemia.

Symptoms and Signs

The most common symptoms include:

  • Fever
  • Unexplained weight loss or appetite loss
  • Weakness or fatigue
  • Pain or fullness below the ribs
  • Shortness of breath
  • Easy bruising
  • Night sweats
  • Enlarged lymph nodes 

These symptoms and signs can have many causes and may not be due to cancer. However, it is important that you discuss these symptoms with your primary care doctor.

Growth and Spread

ALL is often an aggressive cancer. It can involve lymph nodes, spleen, bone marrow and blood, skin, or the central nervous system.

Factors Affecting Prognosis

As with any cancer, prognosis (chance of recovery) and long-term survival can vary greatly. The prognosis can depend on age, genetic subtype, and response to therapy. ALL is a complicated diagnosis and our clinicians are familiar with the latest data; this allows our team to provide tailored treatment recommendations, recommend appropriate clinical trials, and determine the need for stem cell transplant consultation.

Age

Historically, outcomes for older children and adults were poorer than young children.

Young Adults: Our researchers have helped improve survival of adolescents and young adults (AYAs) by showing that AYAs do better when treated on pediatric protocols. (DeAngelo, Leukemia 2015)

  • We have extensive expertise treating young adults with pediatric style ALL regimens.
  • We have several open clinical trials for young adults diagnosed with ALL, including protocol 21-272, which is studying a new form of asparaginase in younger adults.

Older Adults: Our team is helping improve outcomes in older adults through clinical trials of new therapies.

  • We have open clinical trials for older adults diagnosed with ALL (16-648).
  • A geriatrician is part of the team dedicated to care for older adults with ALL.

Genetic Subtype

 A common abnormality in adult ALL is the Philadelphia chromosome. Survival has improved for patients with this disease subtype if treated with targeted therapy. A current clinical trial for adults with Philadelphia chromosome-positive ALL (18-170) is evaluating a new targeted therapy (TKI inhibitor) for this form of ALL.

Response to Therapy

It is important that response to therapy be carefully monitored through specialized tests at our center so we can plan further treatment as needed. We have clinical trials of novel therapies (protocol 21-196) and CAR-T cells (protocols 18-608 and 20-562) for patients with disease that has not responded to or come back after initial therapy.

We believe access to clinicians familiar with the latest literature and available clinical trials in ALL will give you the best chance at successful treatment.

Dr. Luskin on Leukemia Treatment

Marlise Luskin, MD, MSCE, is a physician in Dana-Farber’s Adult Leukemia program. She treats patients with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), myelodysplastic syndrome, and a number of other blood cancers. Luskin discusses her approach to a patient’s first visit, and helping patients understand their disease and treatment options.

Why Choose Us

When choosing a treatment center for acute lymphoblastic leukemia (ALL), you want a team of experienced and compassionate experts. The Adult Leukemia Program team at Dana-Farber Brigham Cancer Center has extensive experience caring for patients with ALL and are world leaders in advancing the treatment of leukemia.

Our team of experts concentrate exclusively on people with leukemia. While ALL is rare in adults, our Adult Leukemia Program cares for a high volume of patients with ALL and has experience caring for newly diagnosed and relapsed patients. Dana-Farber physicians are recognized as international leaders, and have helped establish standards for treating ALL in younger patients, ALL in older patients, ALL with the Philadelphia chromosome, and ALL that has come back after prior therapy.

We provide comprehensive services to patients with these cancers, including:

  • Personalized treatment plans, ranging from standard supportive care to intensive chemotherapy for acute leukemia
  • Access to new therapies through clinical trials available for newly diagnosed and relapsed ALL patients based on age, disease sub-type, and treatment phase
  • Close collaboration with the experts in our Bone Marrow Transplantation Program — one of the largest and most experienced programs in the world
  • Access to the latest diagnostics, such as molecular and genomic profiling, including the Rapid Heme Panel, which was developed by our scientists to rapidly detect key mutations that are important for developing timely treatment plans
  • Second opinion consultation for patients and physicians, nationally and internationally
  • Multidisciplinary care delivered by specialists from Dana-Farber Cancer Institute and Brigham and Women’s Hospital
  • Treatment from the No. 1 cancer center in New England, ranked by U.S. News & World Report