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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


Acute lymphoblastic leukemia

About ALL

Most blood cells are made in the bone marrow. Bone

marrow is the soft, sponge-like tissue in the center of

most bones.

See Figure 1

. Blood cells are made

from special blood-forming cells called blood stem

cells. Blood stem cells can become any type of

mature blood cell.

Blood stem cells go through a series of changes as

they grow and develop to make new blood cells.

See Figure 2.

Blast cells are new, very young

(immature) blood cells that grow into adult (mature)

blood cells over time. Different types of blast cells

become different types of mature blood cells. Once

they are mature, the blood cells leave the bone

marrow and enter the bloodstream.

About ALL

Leukemias are cancers that start in blood-forming

cells in the bone marrow. There is more than one

type of leukemia. Each type of leukemia is named

based on how fast it grows and the type of blood cell

in which it begins.

This book focuses on ALL (






eukemia). “Acute” means the leukemia grows and

progresses very fast. “Lymphoblastic” means it starts

in young white blood cells called lymphoblasts.

Lymphoblastic lymphoma is similar to ALL. The main

difference is that it starts in lymphoblasts within the

lymphatic system.

Figure 2

Blood stem cells make all

types of blood cells

A blood stem cell goes through

many steps to become a red

blood cell, white blood cell, or

platelet. Blast cells are very

young blood cells that grow

into mature blood cells over

time. Lymphoblasts grow into

mature white blood cells called

lymphocytes. White blood cells

help protect the body from

infection and disease.

Red blood




Myeloid stem cell

Blood stem cell



Lymphoid stem cell



Illustration Copyright © 2017 National Comprehensive Cancer Network