Acute Lymphoblastic Leukemia at Fred Hutchinson Cancer Research Center

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 >

Lowering the risk of graft-vs.-host disease -  Dr. Marie Bleakley's researach is focused on improving outcomes for patients with high-risk leukemia by developing new strategies that optimize the activities of T cells in the context of HCT. In particular, she is working to promote the advantageous Graft-Versus-Leukemia (GVL) effect and reduce the potentially dangerous GVHD that also can be caused by donor T cells after allogeneic transplantation. 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 >

Advanced leukemia patients achieve remission - Drs. David Maloney and Cameron Turtle published their first set of results of participants with B-cell acute lymphocytic leukemia, or ALL, who went into complete remission after their T cells were re-engineered into cancer killers — even though multiple other treatments had already failed them. 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 >

Dr. David Maloney is the medical director for cellular immunotherapy at Fred Hutch and the Immunotherapy Clinic at Seattle Cancer Care Alliance. 

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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 >

Measuring cancer-related distress - Drs. Karen Syrjala, Jean Yi, and Shelby Langer from the Clinical Research Division set out to define a reliable and valid distress measure for HCT-treated cancer patients. Importantly, the measure needed to be minimally burdensome to patients. Learn more >

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