Understanding the Status of Your Acute Lymphocytic Leukemia

Most types of cancer are staged to communicate the size of the tumor and how far the cancer has spread. But leukemia rarely causes tumors. Because it is in your bone marrow and blood, it already has spread all over your body. With acute lymphocytic leukemia (ALL), doctors use different terms to describe the response of the leukemia to treatment.

• Untreated ALL. Your doctor has just diagnosed you with ALL. Your complete blood count (CBC) is abnormal. The percentage of blasts, immature white blood cells, in your bone marrow is typically more than 20 percent. You probably have symptoms of leukemia, such as pain, fever, and bleeding. Your treatment has been for symptom relief only.

• ALL in remission. You have received treatment for ALL. During this phase, your CBC is normal. The percentage of blasts in your bone marrow is less than five percent. You have no signs or symptoms of leukemia anywhere in your body.

• Minimal residual disease. Your ALL appears to be in remission, but sensitive lab tests still detect leukemia cells in your bone marrow. Your ALL may be more likely to relapse, so you may benefit from further treatment to try to kill the remaining cells.

• Refractory ALL. The leukemia has not gone away and is not responding to treatment. 

• Relapsed ALL, also called recurrent ALL. Your leukemia has returned after a period of remission. Your symptoms may return and  your CBC becomes abnormal again. The percentage of blasts in your bone marrow is more than five percent. Your doctor may need to consider a new treatment plan to bring you back into remission.