Acute Lymphoblastic Leukemia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Acute Lymphoblastic Leukemia?
A hematologist (a blood doctor) or a medical oncologist (a cancer doctor) treats acute lymphoblastic leukemia. In children, a pediatric oncologist (a children's cancer doctor) usually leads care. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is acute lymphoblastic leukemia?
Acute lymphoblastic leukemia (ALL) is a fast-growing cancer of a type of white blood cells called lymphocytes. Lymphocytes are white blood cells that normally help your body fight infection. ALL starts in the bone marrow, the soft, spongy tissue inside bones that makes blood cells.
In ALL, the bone marrow makes many immature lymphocytes called lymphoblasts. These cancer cells grow quickly and replace normal cells. This leaves less room for healthy white blood cells, red blood cells, and platelets. Infection, anemia (a low red blood cell count), and easy bleeding can happen. Acute means it usually gets worse quickly if it is not treated. ALL is the most common type of cancer in children, but it can also affect adults.
Symptoms
Early signs can look like the flu or other common illnesses. Check with your doctor if you have:
- Weakness or fatigue, which means feeling very tired.
- Fever or drenching night sweats.
- Easy bruising or bleeding.
- Petechiae, flat pinpoint spots under the skin caused by bleeding.
- Weight loss or loss of appetite.
- Pain in the bones or stomach.
- Pain or feeling of fullness below the ribs.
- Painless lumps in the neck, underarm, stomach, or groin.
- Frequent infections.
These symptoms can also be caused by other conditions.
Causes and who gets it
Most of the time, no clear cause can be found for ALL. It is caused by certain changes to the way blood stem cells function, especially how they grow and divide. Things that raise the chance of getting ALL include past treatment with chemotherapy or radiation therapy and being exposed to high levels of radiation in the environment, such as nuclear radiation. Certain genetic disorders, such as Down syndrome, also raise the risk. Having a brother or sister with leukemia raises the risk too. Having a risk factor does not mean that you will get ALL.
This type of leukemia usually affects children ages 3 to 7.
How doctors diagnose it
Your doctor will do a physical exam and ask about your symptoms. Tests may include:
- Complete blood count (CBC), a test that counts the different cells in your blood.
- Platelet count, a test that counts the cells that help stop bleeding.
- Bone marrow biopsy, a test that takes a small sample of marrow to look for leukemia cells.
- Lumbar puncture (spinal tap), a test of the fluid around the brain and spine to check for leukemia cells.
Tests are also done to look for changes in the DNA inside the abnormal white cells. These changes can guide treatment.
Treatment
Chemotherapy is the first treatment tried, with the goal of remission. Remission means the blood counts return to normal and the bone marrow looks healthy. Chemotherapy is given into the veins (by IV) and sometimes into the fluid around the brain and spine. Chemotherapy by mouth may be given after remission. Newer treatments include CAR-T-cell therapy and targeted agents such as blinatumomab and inotuzumab ozogamicin, which have improved outcomes. If tests show the Philadelphia chromosome (a gene change in the leukemia cells), a targeted medicine such as imatinib or dasatinib is used, often with chemotherapy.
After remission, more treatment is given with the goal of a cure. This can include more IV chemotherapy, radiation to the brain, or a stem cell transplant. A stem cell transplant replaces blood-forming cells after chemotherapy. Cancer treatment also destroys healthy cells, so your care team will watch your blood counts closely.
When to see a doctor
Get medical care right away if you have a fever, easy bruising or bleeding, or frequent infections. ALL grows fast, and life-threatening symptoms can occur as normal blood counts drop. Call 911 right away if you have trouble breathing, bleeding that will not stop, a seizure, fainting, or confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can order blood tests and refer you to a cancer specialist. During treatment, they can help watch for infections.
Common questions
Is acute lymphoblastic leukemia the same as leukemia?
No. Leukemia is a term for cancers of the blood cells. ALL is one type of leukemia. It starts in the bone marrow and affects lymphocytes. The word acute means it usually gets worse quickly if it is not treated.
Who gets acute lymphoblastic leukemia?
It usually affects children ages 3 to 7 and is the most common childhood cancer. It can also occur in adults.
What is remission?
Remission means that blood counts return to normal and the bone marrow looks healthy under the microscope. Chemotherapy is the first treatment tried with the goal of remission. After remission, more treatment is given with the goal of a cure.
What raises the risk of getting it?
Past treatment with chemotherapy or radiation therapy raises the risk. So does exposure to high levels of radiation in the environment. Certain genetic disorders, such as Down syndrome, raise the risk, as does having a brother or sister with leukemia. Having a risk factor does not mean that you will get ALL.
Sources
- MedlinePlus - Acute lymphoblastic leukemia (ALL)
- NCI - Acute Lymphoblastic Leukemia Treatment
- MedlinePlus - Acute Lymphocytic Leukemia
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
