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How Does Acute Lymphoblastic Leukemia Occur?

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Published on December 13, 2019

What is acute lymphoblastic leukemia (ALL)? Leading expert Dr. Ryan Cassaday from Fred Hutchinson Cancer Research Center explains how ALL develops in the body, what blast cells are, and some early signs and symptoms of the disease. Watch now to learn more about the biological features of an ALL diagnosis.

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Transcript | How Does Acute Lymphoblastic Leukemia Occur?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello.  I'm Andrew Schorr from Patient Power, and we are talking about acute lymphoblastic leukemia, ALL, certainly a very serious acute, urgent diagnosis.  And a leading specialist in it is Dr. Ryan Cassaday.  He joins us from University of Washington and the Fred Hutchinson Cancer Research Center in Seattle.  Dr. Cassaday, thanks for being with us. 

Dr. Cassaday:

Thank you, Andrew.  It's a pleasure. 

Andrew Schorr:

Just so we understand, maybe you could just give us the layman's definition of acute lymphoblastic leukemia.  What's gone wrong?  

Dr. Cassaday:

So acute lymphoblastic leukemia is a blood cancer of a cell called a lymphoblast.  So lymphoblasts are immature blood cells that when they mature normally give rise to an important part of our immune system called lymphocytes.  They are either B‑cells or T‑cells.  These are very highly specialized cells in the immune system that do a lot of really important work in our body's response to infection and inflammation and so forth. 

These immature cells that give rise to those mature cells, if he they start to develop abnormalities in their genetic code they can start to divide abnormally, not mature properly, and then these cells start to expand.  Normally they occupy a very small proportion of our blood and marrow system, but in a person with ALL, acute lymphoblastic leukemia, these cells basically just start to accumulate and proliferate and divide like crazy to the point where they overrun a person's bone marrow, they're spilling out into their blood, they can involve lymph nodes and spleen and so forth.  

So as the name sort of implies, acute, these cells tend to grow very quickly.  So people will often come to medical attention thinking they just have the flu because they've been feeling kind of unwell, fevery, not eating much or something for just a few days or a week or so, then 99 times—or probably 999 times out of a 1,000, yeah, it's just the flu, but every once in a while it turns out, boom, you have acute leukemia, and it's clearly a very different sort of pathway. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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