About--Acute lymphoblastic leukemia (A.L.L.) caught in very late stages and spread to the brain?

Let's say you've been having many of the general symptoms (unexplained and excessive bruising, breathlessness, weakness, loss of appetite, etc. etc.) but you ignore them and don't let them worry you. You don't think anything of the symptoms, you figure you're simply sick. You tell worried family members and friends not to worry about it and they stop worrying.

And then you get cut pretty bad, but it normally wouldn't be too terrible. It'd stop bleeding and you could bandage it up. However, it doesn't stop bleeding for a long time. So you go to the hospital and you finally admit to your symptoms and they decide to do a blood test and a few other tests. They fix your cut up and send you home and tell you to come back the next night. They find you're severely anemic and your white blood cell count is way too high. They keep you at the hospital the next night to monitor you and do some other tests. You start getting extremely sick because your cut has somehow gotten infected even with the stuff they gave you to protect it from getting it infected. They also start to figure with the other test results that you have leukemia. They rush you around and do other tests to find out the type of leukemia (ends up as A.L.L.) and how to treat it, etc. In that they find out it has spread to your brain.

What are the chances of survival? (The person is a 17 year old otherwise healthy guy.) What would be their next step after they found out it spread to the brain? If he is going to die, how long would he have? And point out if I've got any facts wrong in the process above as well haha.

I'm writing fiction, so don't worry about me. Just a scenario I thought up and researched a load for. I can't find anything specific like this though. :P THANKS!


What happened to my answer O_o

1 Answer

  • ?
    Lv 7
    10 years ago
    Favorite Answer

    ALL in a 17 year old with CNS involvement still has a fairly high survival rate compared to other kinds of cancer. He will be treated for 3+ years. Prognosis is not as good if it's T-Cell ALL instead of the more common pre-B cell, or if he is positive for the Philadelphia chromosome (prognosis is poor for this without bone marrow transplant.)

    However... the way you wrote it out is really not how it generally happens. If the bleeding won't stop and other symptoms lead them to do blood work, they'd know before he left the ER that there is a likelihood of leukemia, and admit him then. The bleeding would be from very low platelets, which would be alarming enough. Then the anemia and high white blood cell count would make them think the kid might have leukemia. They wouldn't send him home and tell him to come back teh next night.

    He'd be admitted, and they would send further blood work for a peripheral blood smear. This can sometimes diagnose leukemia, if blasts (leukemia cells) are seen. They can even sometimes determine the exact type of leukemia and subtype, seeing that it's pre-B ALL, for example, from the peripheral blood smear. Either way, he'd have a bone marrow aspiration the next morning, and possibly a spinal tap. The spinal tap would be to determine if the leukemia has spread to the central nervous system.

    It's really best to write about what you know. It will be impossible for you to portray this accurately without having intimate knowledge of it.

    Source(s): Work in pediatric oncology.
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