Acute Lymphoblastic Leukemia
Navigating Acute Lymphoblastic Leukemia: The Role of Hematopathology
Acute Lymphoblastic Leukemia (ALL) is a fast-growing cancer that originates in the bone marrow and affects the production of white blood cells. While it can occur at any age, it’s more common in children. Of the roughly 4000 cases each year, the majority of patients are under the age of 18 ¹.
Diagnosing and treating ALL requires a comprehensive approach, and at the forefront of this battle is hematopathology—the study of diseases of the blood and bone marrow.
Hematopathologists carefully examine and interpret test results in every stage of this disease, including diagnosis, treatment planning, and monitoring response to therapy.
Diagnosis: The First Step
Hematopathologists are necessary when a patient presents with symptoms suggestive of leukemia, such as fatigue, frequent infections, night sweats, easy bruising or bleeding, pale skin, shortness of breath, and/or abnormal laboratory tests.
A bone marrow biopsy and peripheral blood smear are two advanced forms of testing that can confirm the diagnosis. Hematopathologists meticulously examine these samples and look for abnormal cells, their characteristics, and any genetic abnormalities that could indicate ALL.
Because this cancer worsens quickly without treatment, an accurate diagnosis improves outcomes and ensures patients receive the correct treatment.
Treatment Planning: Tailored Precision
Once diagnosed, hematopathologists help physicians create a treatment plan. Different subtypes of ALL exist, each requiring a tailored approach. Hematopathology helps in identifying these subtypes through techniques like immunophenotyping and cytogenetic analysis.
Doctors have found that cytogenetic tests, flow cytometry, and other lab tests provide more detailed information about the subtype of ALL and the patient’s prognosis ². These tests help divide ALL into groups based on the gene and chromosome changes in the leukemia cells.
Understanding the subtype helps oncologists choose the most effective treatment regimen, which may include chemotherapy, targeted therapy, radiation, or stem cell transplantation. The most common treatment for ALL is chemotherapy, which most people get for at least 2 years.
Monitoring Response to Therapy
Throughout treatment, hematopathologists help monitor the patient’s response. Regular assessments and laboratory testing allow healthcare providers to evaluate the effectiveness of the chosen therapy.
ALL treatment usually has three phases ³. The induction phase clears the blood of all leukemia cells. The second phase, consolidation, kills any leftover leukemia cells and keeps the ALL from coming back. The final maintenance phase keeps the ALL from coming back by using doses of chemotherapy drugs given over time (about 2 years).
Changes in leukemic cells provide valuable insights into treatment efficacy and help in modifying the regimen if necessary. This close monitoring ensures that the patient receives the most appropriate care tailored to their response.
Even after successful treatment, patients and their healthcare teams must remain vigilant. Hematopathologists continue to assist with monitoring patients during remission to detect any signs of relapse early on. Their expertise ensures that any recurrence is promptly addressed, maximizing the chances of successful re-treatment.
Choose HNL Lab Medicine for Your Lab Testing
HNL Lab Medicine has everything patients need, including an expert hematopathology team. Acute lymphoblastic leukemia is a formidable opponent, but you can trust in our hematopathologists to process your laboratory testing with diligence and care.
Their expertise, dedication, and precision saves lives and helps patients access the most appropriate treatments for their illness.
Count on HNL Lab Medicine to provide more than just medical care; our team is dedicated to walking alongside you, offering compassion and empathy as you navigate your journey to wellness.
REFERENCES
¹ Puckett, Y., & Chan, O. (2023). Acute Lymphocytic Leukemia. In StatPearls. StatPearls Publishing.
² American Cancer Society. (2018, October 17). Acute lymphocytic leukemia (ALL) subtypes and prognostic factors. https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/detection-diagnosis-staging/how-classified.html.
³ American Cancer Society. (2018, October 17). If you have acute lymphocytic leukemia (ALL). https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/if-you-have-acute-lymphocytic-leukemia.html.