WHAT IS ALL?

ACUTE LYMPHOCYTIC LEUKEMIA (ALL) IS

ALSO CALLED ACUTE LYMPHOBLASTIC
LEUKEMIA. “ACUTE” MEANS THAT THE
LEUKEMIA CAN PROGRESS QUICKLY, AND IF
NOT TREATED, WOULD PROBABLY BE FATAL
WITHIN A FEW MONTHS. "LYMPHOCYTIC"
MEANS IT DEVELOPS FROM EARLY
(IMMATURE) FORMS OF LYMPHOCYTES, A
TYPE OF WHITE BLOOD CELL.

ALL STARTS IN THE BONE MARROW (THE

SOFT INNER PART OF CERTAIN BONES,
WHERE NEW BLOOD CELLS ARE MADE).
MOST OFTEN, THE LEUKEMIA CELLS INVADE
THE BLOOD FAIRLY QUICKLY. THEY CAN
ALSO SOMETIMES SPREAD TO OTHER PARTS
OF THE BODY, INCLUDING THE LYMPH
NODES, LIVER, SPLEEN, CENTRAL NERVOUS
SYSTEM (BRAIN AND SPINAL CORD), AND
TESTICLES (IN MALES). SOME CANCERS
CAN ALSO START IN THESE ORGANS AND
THEN SPREAD TO THE BONE MARROW, BUT
THESE CANCERS ARE NOT LEUKEMIA.
SYMP TOMS

Signs and symptoms of acute lymphocytic leukemia

may include:

Bleeding from the gums

Bone pain
Fever
Frequent infections
Frequent or severe nosebleeds
Lumps caused by swollen lymph nodes in and around the neck,
armpits, abdomen or groin
Pale skin
Shortness of breath
Weakness, fatigue or a general decrease in energy

When to see a doctor

Make an appointment with your doctor or your child's doctor if you notice
any persistent signs and symptoms that concern you.

Many signs and symptoms of acute lymphocytic leukemia mimic those of

the flu. However, flu signs and symptoms eventually improve. If signs and
symptoms don't improve as expected, make an appointment with your
doctor.
 January 16 2024

Acknowledgement

I EXTEND MY SINCERE APPRECIATION TO MY

BIOLOGY TEACHER FOR THEIR GUIDANCE AND
UNWAVERING SUPPORT THROUGHOUT THIS ALL
PROJECT. SPECIAL THANKS TO MY CLASSMATES FOR
THEIR COLLABORATIVE EFFORTS AND VALUABLE
INSIGHTS. GRATITUDE IS ALSO DUE TO TEACHER
MRS RAKHI HAZRA MAM FOR SHARING THEIR
EXPERTISE. I AM THANKFUL TO THE SCHOOL
ADMINISTRATION FOR PROVIDING THE NECESSARY
RESOURCES. LASTLY, HEARTFELT THANKS TO MY
FAMILY FOR THEIR ENCOURAGEMENT. THIS PROJECT
HAS BEEN A COLLECTIVE ENDEAVOR, ANDIAM
GRATEFUL FOR THE CONTRIBUTIONS THAT HAVE
MADE IT POSSIBLE.

NRUPESH KUMAR MOHANTY

CLASS:-XI "B"

ROLL NO.:-31
 CERTIFICATE

THIS IS TO CERTIFY THAT NRUPESH KUMAR

MOHANTY OF XI HAS COMPLETED THE BIOLOGY
PROJECT ON ACUTE LYMPHOCYTIC LEUKEMIA
THIS PROJECT DEMONSTRATES A COMMENDABLE
UNDERSTANDING OF THE BIOLOGICAL PROCESSES
INVOLVED IN ALL HIGHLIGHTING THE COUSE & CURE
OF ALL.
PROJECT ADVISOR: MRS RAKHI HAZRA MAM
DATE OF COMPLETION: 18/01/2024

WE APPLAUD THE DEDICATION, EFFORT, AND

CREATIVITY INVESTED IN THIS PROJECT,
SHOWCASING A COMMITMENT TO EXCELLENCE IN
BIOLOGY THIS CERTIFICATE IS AWARDED IN
RECOGNITION OF OUTSTANDING ACHIEVEMENT.

SCHOOL SEAL WITH TEACHER SIGNATURE

 Content
Sl. no.

1) What is ALL?

2) Types of ALL

3) Causes

4) Symptoms

5) Diagnosis & Tests

6) Treatment

7) Prevention

8) Survival
 Cause of ALL
Acute lymphocytic leukemia occurs when a bone marrow cell develops changes
(mutations) in its genetic material or DNA. A cell's DNA contains the instructions
that tell a cell what to do. Normally, the DNA tells the cell to grow at a set rate
and to die at a set time. In acute lymphocytic leukemia, the mutations tell the bone
marrow cell to continue growing and dividing.

When this happens, blood cell production becomes out of control. The bone
marrow produces immature cells that develop into leukemic white blood cells
called lymphoblasts. These abnormal cells are unable to function properly, and
they can build up and crowd out healthy cells.

It's not clear what causes the DNA mutations that can lead to acute lymphocytic
leukemia.

Risk factors
Factors that may increase the risk of acute lymphocytic leukemia include:

Previous cancer treatment. Children and adults who've had certain types of
chemotherapy and radiation therapy for other kinds of cancer may have an
increased risk of developing acute lymphocytic leukemia.
Exposure to radiation. People exposed to very high levels of radiation, such as
survivors of a nuclear reactor accident, have an increased risk of developing
acute lymphocytic leukemia.
Genetic disorders. Certain genetic disorders, such as Down syndrome, are
associated with an increased risk of acute lymphocytic leukemia.
 Treatment
phases
Introduction therapy
The purpose of the first phase of treatment is to kill most of the
leukemia cells in the blood and bone marrow and to restore normal
blood cell production.

Consolidation therapy
Also called post-remission therapy, this phase of treatment is aimed
at destroying any remaining leukemia in the body.

Maintenance therapy
The third phase of treatment prevents leukemia cells from regrowing.
The treatments used in this stage are usually given at much lower
doses over a long period of time, often years.

Preventive treatment to the spinal code

During each phase of therapy, people with acute lymphocytic
leukemia may receive additional treatment to kill leukemia cells
located in the central nervous system. In this type of treatment,
chemotherapy drugs are often injected directly into the fluid that
covers the spinal cord.

Depending on your situation, the phases of treatment for acute

lymphocytic leukemia can span two to three years.
Treatment may include:
Chemotherapy. Chemotherapy, which uses drugs to kill cancer cells, is typically used as
an induction therapy for children and adults with acute lymphocytic leukemia.
Chemotherapy drugs can also be used in the consolidation and maintenance phases.
Targeted therapy. Targeted drug treatments focus on specific abnormalities present
within cancer cells. By blocking these abnormalities, targeted drug treatments can cause
cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be
helpful for you. Targeted therapy can be used alone or in combination with
chemotherapy for induction therapy, consolidation therapy or maintenance therapy.
Radiation therapy. Radiation therapy uses high-powered beams, such as X-rays or
protons, to kill cancer cells. If the cancer cells have spread to the central nervous system,
your doctor may recommend radiation therapy.
Bone marrow transplant. A bone marrow transplant, also known as a stem cell
transplant, may be used as consolidation therapy or for treating relapse if it occurs. This
procedure allows someone with leukemia to reestablish healthy bone marrow by
replacing leukemic bone marrow with leukemia-free marrow from a healthy person.
A bone marrow transplant begins with high doses of chemotherapy or radiation to
destroy any leukemia-producing bone marrow. The marrow is then replaced by bone
marrow from a compatible donor (allogeneic transplant).
Engineering immune cells to fight leukemia. A specialized treatment called chimeric
antigen receptor (CAR)-T cell therapy takes your body's germ-fighting T cells, engineers
them to fight cancer and infuses them back into your body.
CAR-T cell therapy might be an option for children and young adults. It might be used for
consolidation therapy or for treating relapse.
Clinical trials. Clinical trials are experiments to test new cancer treatments and new ways
of using existing treatments. While clinical trials give you or your child a chance to try the
latest cancer treatment, the benefits and risks of the treatment may be uncertain.
Discuss the benefits and risks of clinical trials with your doctor.

Treatment for adults

Older adults, such as those older than 65, tend to experience more complications from
treatments. And older adults generally have a worse prognosis than children who are treated
for acute lymphocytic leukemia.

Discuss your options with your doctor. Based on your overall health and your goals and
preferences, you may decide to undergo treatment for your leukemia.

Some people may choose to forgo treatment for the cancer, instead focusing on treatments
that improve their symptoms and help them make the most of the time they have remaining.
Diagnosis

Fig :- Bone marrow

fig :- Lumbar puncture (spinal tap)

Tests and procedures used to diagnose acute lymphocytic leukemia include:

Blood tests. Blood tests may reveal too many or too few white blood cells,
not enough red blood cells, and not enough platelets. A blood test may also
show the presence of blast cells — immature cells normally found in the
bone marrow.
Bone marrow test. During bone marrow aspiration and biopsy, a needle is
used to remove a sample of bone marrow from the hipbone or breastbone.
The sample is sent to a lab for testing to look for leukemia cells.
Doctors in the lab will classify blood cells into specific types based on their
size, shape, and other genetic or molecular features. They also look for
certain changes in the cancer cells and determine whether the leukemia
cells began from B lymphocytes or T lymphocytes. This information helps
your doctor develop a treatment plan.
Imaging tests. Imaging tests such as an X-ray, a computerized tomography
(CT) scan or an ultrasound scan may help determine whether cancer has
spread to the brain and spinal cord or other parts of the body.
Spinal fluid test. A lumbar puncture test, also called a spinal tap, may be
used to collect a sample of spinal fluid — the fluid that surrounds the brain
and spinal cord. The sample is tested to see whether cancer cells have
spread to the spinal fluid.

Determining your prognosis

Your doctor uses information gathered from these tests and procedures to
determine your prognosis and decide on your treatment options. Other types of
cancer use numerical stages to indicate how far the cancer has spread, but
there are no stages of acute lymphocytic leukemia.

Instead, the seriousness of your condition is determined by:

The type of lymphocytes involved — B cells or T cells

The specific genetic changes present in your leukemia cells
Your age
Results from lab tests, such as the number of white blood cells detected in a
blood sample
 Prevention
There is no known way to prevent most cases of leukemia at this time.
Most people who get acute lymphocytic leukemia have no known risk
factors, so there is no way to prevent these leukemias from developing.

SURVIVAL RATE Body

The 5-year relative survival rate for people age 20 and older is 43%. The 5-
year relative survival rate for people under age 20 is 90%.

Recent advances in treatment have significantly lengthened the lives of

people with ALL. However, the survival rates for the disease vary based on
several factors
100%

80%

60%

40%

20%

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all ALL patient (include childhood all)

all childhood leukemias(0-19)
 Types of Acute Lymphocytic Leukemia
Acute lymphocytic leukemia (ALL) can be characterized into different sub-types:

Philadelphia chromosome-positive ALL

Philadelphia chromosome-negative ALL
B cell ALL
T cell ALL

B cell ALL is more common than T cell ALL. Other names and
sub-types of B cell and T cell ALL include:

Acute B-lymphocytic leukemia

Acute precursor B cell leukemia

Pre-B cell lymphocytic leukemia

Acute T-lymphoblastic leukemia
Your individual treatment plan will depend on your ALL sub-type.

The Philadelphia Chromosome

Some people with ALL have a genetic abnormality referred to as the
Philadelphia chromosome. If you have the Philadelphia chromosome,
you will receive chemotherapy and targeted therapies designed
specifically for you and the genetic makeup of your leukemia. The
Philadelphia chromosome, discovered more than 50 years ago at
Penn, provided the first evidence that genetic abnormalities were
linked to cancer. The discovery ushered in the modern period of
cytogenetics in the understanding of leukemia. Now, the Center for
Personalized Diagnostics builds on this legacy and is set to pave the
way for precision medicine.