Acute Lymphoblastic Leukemia (ALL)

Acute lymphoblastic leukemia (ALL) is a fast-growing cancer of the blood and bone marrow that starts in immature white blood cells called lymphoblasts. These abnormal cells multiply quickly and crowd out healthy blood cells, making it harder for your body to fight infections, carry oxygen, and control bleeding. 

ALL effects about 6,100 people in the U.S. each year, most often children under age 10 and adults over 65. At Columbia, we provide highly personalized care for both pediatric and adult ALL, offering access to the latest therapies and clinical trials, including options for hard-to-treat or relapsed disease. 

What is acute lymphoblastic leukemia (ALL)? 

ALL begins in the bone marrow, where early forms of white blood cells—called lymphocytes—develop abnormally and multiply out of control. These leukemia cells can build up in the blood and spread to other parts of the body, such as the lymph nodes, liver, spleen, and central nervous system. 

Risk factors 

While ALL is not typically inherited, certain genetic conditions—like Down syndrome, Klinefelter syndrome, Fanconi anemia, Bloom syndrome, ataxia-telangiectasia, and neurofibromatosis—can increase a person’s risk.

ALL symptoms 

ALL symptoms can develop quickly and may include fatigue, easy bruising or bleeding, frequent infections, and bone or joint pain. In some cases, swollen lymph nodes or an enlarged spleen may be present. 

ALL diagnosis 

Diagnosing ALL involves blood tests, bone marrow biopsies, and specialized genetic and molecular testing to determine the subtype and how aggressive the disease is. These results help guide treatment planning and determine whether a patient is considered standard-risk or high-risk. 

At Columbia, we treat every patient with ALL as an individual, tailoring care plans based on highly specialized diagnoses, including understanding the molecular features of the disease. 

ALL treatments 

Children and younger adults often respond very well to ALL treatment, while older adults may need more tailored approaches due to other health concerns. Treatment for ALL starts quickly and varies based on: 

• Your specific subtype 
• Whether abnormal chromosomes such as the Philadelphia chromosome are present 
• Your age and general health 
• Past treatment history 

ALL treatment may include: 

• Chemotherapy 
• Targeted therapy (especially for Philadelphia-positive ALL) 
• Immunotherapy 
• Radiation therapy 
• Stem cell transplant 
• Clinical trials for new therapies 

At Columbia, our ALL care is guided by leukemia specialists who focus specifically on acute lymphoblastic leukemia. Our researchers and physicians are national leaders in advancing ALL treatment, and they work closely together to bring you the most effective therapies, including access to cutting-edge clinical trials and advanced transplant programs. Our teams collaborate across disciplines to ensure each patient receives care that is safe, comprehensive, and up to date.