Diseases / Research

Acute Lymphoblastic Leukemia

Acute Lymphoblastic Leukemia

This an example of acute lymphoblastic leukemia in a bone marrow aspirate. The malignant lymphoblasts are the purple cells with large nuclei and minimal cytoplasm. The red cells are mature red blood cells. This is a wright-giemsa stained prep.

Photo by Keith Loeb, PhD, and Sindhu Cherian, MD, SCCA Department of Pathology

Fred Hutch's Nobel Prize-winning researchers spearheaded bone marrow transplantation, one of the most significant advances in treating leukemia, and are pursuing new therapies that train the immune system to fight cancer.

Fast Facts

  • ALL is the most common cancer in children in developed countries. People between the ages of 25 and 50 face the lowest risk of getting the disease, but risk increases after age 50.

  • Acute lymphoblastic leukemia—also called acute lymphocytic leukemia or acute lymphoid leukemia—starts in the bone marrow and often moves quickly into the blood. There are many different subtypes of ALL.

  • In a healthy person, bone marrow makes blood stem cells that mature into infection-fighting white blood cells, oxygen-carrying red blood cells and blood-clotting platelets. When a person has ALL, the marrow makes too many immature white blood cells, called lymphoblasts, which never turn into mature white blood cells. When too many lymphoblasts grow in the marrow, it decreases the growth of red blood cells, other white blood cells and platelets. This can lead to anemia, bruising and frequent infections.

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Treatment & Prognosis

Pioneering bone marrow transplantation – Led by Nobel Prize winner Dr. E. Donnall Thomas, Fred Hutch researchers have transformed bone marrow transplantation into standard treatment for leukemia and other blood cancers. The procedure is widely recognized as one of the greatest achievements in cancer treatment and has saved hundreds of thousands of patients' lives. Learn more >

Using radiation therapy to save infants – Our team achieved unprecedented success at using total-body irradiation to wipe out ALL in infants. Our studies also show that, contrary to popular medical opinion, the radiation therapy did not cause long-term side effects in infants with ALL. Learn more >

Advancing bone marrow transplants in children – Our researchers showed that children with ALL can successfully receive bone marrow transplants from tissue-matched but unrelated donors. The study indicated that doctors can be more aggressive in recommending bone marrow transplants for children with ALL who don't have a tissue-matched relative to donate bone marrow.  Learn more >

Pinpointing side effects – A large study by Hutch researchers found that survivors of childhood ALL have an increased chance of being significantly shorter in height as adults, as compared with their siblings. Although that effect may be largely cosmetic, researchers are studying how the long-term effects of treatments like chemotherapy and radiation can affect risk for obesity, early death from cardiovascular disease, and developing a second cancer. Learn more >

Using the immune system to fight cancer – Dr. Stanley Riddell and colleagues are investigating how the body’s own infection-fighting T-cells can be used to fight a variety of cancers. The approach, known as immunotherapy, holds promise for treating several types of cancer, including chemotherapy-resistant ALL in children. 
Learn more >

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Improving Survivorship

Recovering from "chemo brain" – Research by Dr. Karen Syrjala shows that the decline in mental skills experienced by many bone marrow and stem cell transplant patients is largely temporary. Patients who experience these symptoms can expect a return to normal cognitive functions within a year of their transplant, and the mental conditions continue to improve. Learn more >

A bright future for survivors – A study by Dr. Syrjala shows that, after 10 years, survivors of stem cell transplants for blood cancers are nearly as healthy as people who didn’t undergo the procedure. Both populations had similar rates of asthma, diabetes, high blood pressure, high cholesterol and osteoporosis. In addition, they also had similar psychological health, marital satisfaction and employment. Learn more >

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