Infant ALL

What is Infant Acute Lymphoblastic Leukemia (ALL)?

Infant ALL is a relatively uncommon type of leukemia and occurs in children less than 12 months of age. It occurs in approximately 2-4 percent of all childhood ALL cases. Research has shown that infant ALL represents a distinct and unique biological subtype of leukemia. The prognosis for infants with ALL is much less favorable than for older children with ALL.

What are the signs and symptoms of Infant ALL?

Most patients with ALL have too many immature white cells in their blood, and not enough normal white blood cells (help to fight infections), red blood cells (carrying oxygen to tissues) or platelets (help to form a clot and prevent bleeding). Many of the white blood cells will be lymphoblasts, which are immature lymphocytes (leukemia cells) not normally found in the bloodstream. Lymphoblasts do not function like normal mature white blood cells. Patients with ALL are very susceptible to life-threatening infections.

Common symptoms and signs include:

• Fever
• Fatigue, lethargy, loss of appetite and weight loss
• Bleeding, easy bruising or multiple pinhead-sized red spots on skin
• Bone pain, which may cause older children to limp or make them unable to walk

How is Infant ALL diagnosed?

Complete blood count (CBC) and blood cell exam (peripheral blood smear) are often the first ones done on patients with a suspected blood problem. Those tests that show immature lymphoblasts (leukemia cells) may also show decreased numbers of red cells (anemia) and platelets (thrombocytopenia).

Samples of the bone marrow – red tissues in the bones that produce all cells found in the blood – are obtained by bone marrow aspiration and biopsy – tests that are usually performed to help and diagnose and confirm leukemia. These procedures may also be done again later to inform the physicians if the leukemia is responding to treatment.

What are the treatment options for Infant ALL?

Treatment for infants with ALL is very difficult and remains a significant challenge.
All children with leukemia are treated with aggressive regimens with chemotherapy. Some children may also receive radiation therapy, bone marrow transplant, or a combination of both.

Courtesy of:
Dr. Hasan Hashem, M.D. Pediatric Heme/Onc Fellow, Rainbow Babies & Children’s Hospital
Dr. Alex Huang, M.D., Ph.D. Associate Professor of Pediatrics, Case Western Reserve University School of Medicine