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Stages of Adult Acute Lymphoblastic Leukemia

Once adult acute lymphoblastic leukemia (ALL) has been diagnosed, tests are done to find out if the cancer has spread to the central nervous system (brain and spinal cord) or to other parts of the body.

The process used to find out if cancer has spread is called staging. It is important to know whether the leukemia has spread outside the blood and bone marrow in order to plan treatment.

The following tests and procedures may be used to find out if the leukemia has spread:

  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Lumbar puncture: A procedure used to collect a sample of cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that leukemia cells have spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of the abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

There is no standard staging system for adult ALL.

The disease is described as untreated, in remission, or recurrent.

Untreated adult ALL

In untreated adult ALL, the disease is newly diagnosed. It has not been treated, except to relieve signs and symptoms caused by the cancer, such as fever, bleeding, or pain, and the following are true:

  • The complete blood count (CBC) is abnormal.
  • More than 5% of the cells in the bone marrow are blasts (leukemia cells).
  • There are signs and symptoms of leukemia.

Adult ALL in remission

In adult ALL in remission, the disease has been treated, and the following are true:

  • The CBC is normal.
  • 5% or fewer of the cells in the bone marrow are blasts (leukemia cells).
  • There are no signs or symptoms of leukemia other than in the bone marrow.

Recurrent adult ALL

Recurrent adult ALL is cancer that has recurred (come back) after going into remission. The ALL may come back in the blood, bone marrow, or other parts of the body.

This information is not intended to replace the advice of a doctor. Navigating Care disclaims any liability for the decisions you make based on this information. This information was sourced and adapted from Adapted from the National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries on www.cancer.gov.