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Acute Lymphoblastic Leukemia (ALL)

Acute Lymphoblastic Leukemia (ALL) is the most common form of childhood cancer. About 120 children get ALL each year in the Netherlands. ALL occurs in children of all ages, with a peak around the age of three and four. In acute lymphoblastic leukemia, there is an unrestrained division and growth of lymphocytes, a certain type of white blood cells. This means there is no room left for the production of healthy blood cells.

Symptoms of this disease

Due to a shortage of healthy white blood cells, children can suffer from recurring infections and fever. The reduced production of red blood cells results in anemia, which causes the children to look pale and often feel tired and lethargic. Blood noses, rapidly occurring bruises, small purple-red spots and wounds that won't stop bleeding are the result of a shortage of platelets. Many children with leukemia suffer from bone pain. That is because the pressure in the bone marrow is large and the immature blood cells stimulate the bone membrane. Finally, they may have swollen lymph nodes and an enlarged liver or spleen.

How do we make the diagnosis?

Sometimes the diagnosis of leukemia can be made by blood tests, but in most cases, bone marrow and cerebrospinal fluid must also be taken. This happens under a light anesthetic.

Treatment of ALL

Children with ALL are treated according to a national protocol. The treatment (always) consists of combinations of drugs that inhibit cell division (chemotherapy) and lasts about two or three years. The first part of the treatment, more than 7 months, is the most intensive. The intensity of the treatment depends on the speed with which the leukemia reacts to the treatment and on certain molecular changes in the leukemic cells. Most children have to go to the hospital for chemotherapy every week for two years.

Children with ALL who are in a high-risk group are eligible for allogeneic stem cell transplantation. That is a transplant with stem cells from the bone marrow, the umbilical cord or the blood of a healthy donor.


Children and teenagers with ALL are treated in the Hematology-oncology department.

Telephone 088-9727272