Acute lymphocytic leukemia is also called acute lymphoblastic leukemia or ALL. This disease is primarily when the white blood cell, WBC, making tissue releases too many undeveloped lymphocytes. The immature lymphocytes then collect in lymph tissues. The tissues swell which makes it harder for the bone marrow to produce other blood cells. If the bone marrow cannot function properly the red blood cell, RBC, count decreases causing anemia. The bone marrow also cannot create the platelets needed to cause clots, therefore resulting in the body bleeding and bruising more easily. The lymphocytes can also invade other organs, impairing their ability to function properly. ALL accounts for twenty-five percent of cancers affecting children under the age of fifteen. It is most prevalent in children between the ages of two and five and adults over the age of forty-five. (Freireich, 2008) Men are more likely to develop ALL. In 2007, the median age for diagnosis of ALL was 13 years old and the average age of death was 49 years old. The average survival rate for ALL is sixty percent. ALL infects 2,500–3,500 children and less than 1000 adults are diagnosed will ALL each year (Altekrus, 2010). Leukemia treatments are very expensive. The cost for one round of chemotherapy can cost around 150,000 dollars. For most cases of ALL more than one round of chemotherapy is needed. In addition to this, the client may need a bone marrow transplant. This costs around 250,000 dollars. There are addition costs for doctors visits, antibiotics, hospital stays, blood transfusions, and after care. All of these costs add up can add up to over a million dollars. Cancer accounts for 104.1 billion dollars of medical expenses each year in the United States. Leukemia accounts for 4.507 billion dollars (N.A., 2010)
It is believed that ALL is started by a single progenitor cell that reproduces at a fast rate, multiple times. The leukemic cells start in either B or T lymphocytes. Approximately 80% of cases start with immature B cells. One to two percent are mature B cells. Fifteen to twenty percent of all cases are derived from T cells. These cases are associated with cases that occur in older males and a need for a higher dosage of chemotherapy. In addition, the chromosomes play an important part in the diagnosis of the subtype of ALL. The TEL-AML1 fusion gene can indicate an early B cell type of leukemia. This gene also indicates a favorable prognosis. The bcr-abl t translocation gene is seen in three to five percent of all cases. Those diagnosed with ALL that have this gene will have a higher WBC count and a poorer prognosis. A rearrangement of the MLL gene accounts for 80% of infant ALL cases. The prognosis for this is poor despite the use of high intensity chemotherapeutics. There is only a twenty percent survival rate (Esparza, Sakamoto, 2005).
Manifestation of the Disease
When diagnosing ALL a complete patient history is taken. The client would present with...