What is acute lymphocytic leukemia?
Acute lymphocytic leukemia (ALL) is a type of cancer that starts in the blood and bone marrow, where new blood cells are made. It happens when the body makes too many immature white blood cells, called lymphoblasts. These cells don’t work the way they should. Instead of helping fight infection, they build up in the bone marrow and bloodstream, leaving less room for healthy blood cells. ALL is considered acute, meaning it develops quickly and needs timely treatment.
Sometimes called acute lymphoblastic leukemia, ALL is the most common type of leukemia in children, though it can also affect adults. With the right care, many people respond well and move forward with their lives.
Penn Medicine provides coordinated care for people with ALL, led by specialists in blood cancers. Care is designed around the individual, bringing together expertise, communication, and support at every step.
Types of acute lymphocytic leukemia
ALL includes several subtypes. These are based on the type of white blood cell involved and specific genetic changes in the leukemia cells. Common subtypes include:
- B-cell ALL, the most common type, also called acute B-lymphocytic leukemia, precursor B-cell leukemia, or pre-B-cell leukemia
- T-cell ALL, also called acute T-lymphoblastic leukemia
Some cases of ALL are further classified based on genetic findings in the leukemia cells, such as:
- Philadelphia chromosome-positive ALL
- Philadelphia chromosome-negative ALL
Your individual treatment plan will depend on your ALL sub-type.
Understanding the Philadelphia chromosome
Some people with ALL have a genetic abnormality called the Philadelphia chromosome. When this chromosome is present, treatment typically includes chemotherapy, along with targeted therapies tailored to the specific features of the leukemia.
The Philadelphia chromosome was discovered more than 60 years ago at the University of Pennsylvania School of Medicine. It was the first genetic change linked to cancer. This discovery showed that genetic changes play an important role in leukemia and continues to guide how ALL is treated today. The Penn Center for Personalized Diagnostics builds on this work by using advanced genetic testing to support individualized care.
Symptoms and warning signs of ALL
Signs and symptoms of ALL can vary and may overlap with other conditions. These include:
- Body aches
- Bruising easily, or not remembering how you got a bruise
- Enlarged lymph nodes
- High fever without a reason, or a persistent low-grade fever
- Headaches
- Pale skin
- Pinhead-sized red spots under the skin
- Excessive bleeding
- Shortness of breath
- Tiredness, lethargy
- Vomiting
- Unexplained weight loss
Acute lymphocytic leukemia diagnosis at Penn Medicine
Getting an accurate diagnosis of ALL, including the exact type, helps your doctors choose the treatment that’s right for you. Because different types of ALL can respond to different treatments, careful testing is an important first step in your care. Your team may do blood tests, perform a physical exam, and recommend additional tests as needed to better understand your condition.
Personalized treatment for ALL
There are several treatment options for acute lymphocytic leukemia, and not everyone needs the same approach. Your treatment depends on the subtype of your ALL. At Penn Medicine, experts use this information to guide your treatment and help you understand your options every step of the way.
Expert care for acute lymphoblastic leukemia
Penn Medicine offers expert, compassionate care for people with ALL, led by specialists who focus exclusively on blood cancers. Through the Abramson Cancer Center, you’ll have access to advanced testing, the latest treatments—including CAR T cell therapy—and coordinated care from experienced multidisciplinary teams. As a longtime leader in blood cancer research and clinical care, Penn Medicine offers both proven therapies and opportunities to participate in innovative clinical trials.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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How pickleball (and Penn Medicine) saved one patient’s life
With teamwork and determination, specialists at Penn Medicine solved Ronnie Recchia’s life-threatening medical mystery and got him back in the game.
‘You won the lottery’: The very first CAR T cell patient
Bill Ludwig will forever be known as the first person successfully treated with a cellular therapy that kills cancer cells with his own immune system.
Improving care for patients with acute lymphocytic leukemia
A clinical trial gave Becky Yu access to treatment that would become the new standard of care for newly diagnosed acute lymphocytic leukemia.