What is Acute Lymphoblastic Leukaemia (ALL)?
Acute Lymphoblastic Leukaemia (ALL) is a type of blood cancer that starts in the bone marrow, where new blood cells are made. In ALL, immature white blood cells (lymphoblasts) multiply too quickly and do not develop properly. These abnormal cells crowd out healthy blood cells, which can cause tiredness, bruising, infections or bone pain.
ALL can occur at any childhood age, but it is most common in younger children. Although the diagnosis can feel overwhelming, treatments are well established and most children respond very well.
Signs & Symptoms
Symptoms may include:
- looking pale or feeling unusually tired
- bruising easily
- frequent nosebleeds or bleeding gums
- fevers or repeated infections
- bone or joint pain
- swollen glands
- tummy swelling
- loss of appetite or weight loss
These symptoms can also be caused by many other common childhood illnesses and do not necessarily mean cancer.
How is it Diagnosed?
If ALL is suspected, your child will be referred urgently to a specialist children’s cancer centre. Tests may include:
- blood tests – to check blood cell levels
- bone marrow test – to confirm the diagnosis and understand the exact type
- genetic tests – to look for specific changes in the leukaemia cells
- scans such as ultrasound or X-rays – to build a full picture of your child’s health
These results help the team plan the most appropriate treatment.
Treatment
Treatment for ALL is delivered in a planned sequence of phases, often called blocks. The aim is to remove leukaemia cells from the body and stop them from returning. Children are placed into a treatment group based on factors such as age, white blood cell count at diagnosis, genetic features of the disease and how the leukaemia responds early on. This helps decide how intensive the treatment needs to be.
Most treatment is given as an outpatient, although hospital stays are sometimes needed, particularly in the early intensive phases.
The main phases are:
-
Induction Therapy
The first and most intensive stage, designed to remove the majority of leukaemia cells and bring the disease into remission. Children may spend time in hospital during this phase for close monitoring and supportive care. -
Consolidation / Intensification
Once remission is reached, further chemotherapy is given to destroy any remaining leukaemia cells that are too small to detect on standard tests. This phase often includes medicines that protect the brain and spinal cord. -
Interim Maintenance
Used in some treatment protocols. It provides a gentler period of chemotherapy while helping maintain remission and allowing the body to recover before the next intensive block. -
Delayed Intensification
A second period of stronger chemotherapy designed to target any remaining resistant cells. This phase plays an important role in reducing the risk of relapse. -
Maintenance Therapy
The final and longest phase of treatment. Maintenance typically lasts around two years for girls and three years for boys. It usually involves:
- daily chemotherapy at home
- weekly medicines
- monthly hospital chemotherapy
- occasional lumbar punctures
Most children return to school and everyday routines during maintenance.
Supportive Care
Throughout treatment, your child may receive:
- antibiotics or antifungals to prevent infections
- blood or platelet transfusions
- medicines for sickness, appetite or pain
- nutritional support
- physiotherapy, play therapy or psychological support
- help with school and daily activities
Supportive care helps keep treatment safe and manageable.
Monitoring Response
Blood tests, bone marrow tests and minimal residual disease (MRD) testing are used throughout treatment to assess how well the leukaemia is responding. Treatment may be adjusted based on these results.
Outlook & Support
Survival rates for ALL have improved dramatically over recent decades. Many children go on to live full, healthy lives after treatment.
During treatment your child will be cared for by a specialist children’s cancer team. Help is available with managing side effects, school, emotional wellbeing and practical concerns. Lennox Children’s Cancer Fund will support your whole family from diagnosis, through treatment and beyond.
Lennox Children’s Cancer Fund will support your whole family from diagnosis, through treatment and beyond.
Key Facts
- Common Age: Most often diagnosed between 2 and 5 years
- Survival: Around 85–90% of children now survive long term
- How common? ALL is the most common childhood cancer in the UK
