TYPES
When it comes to relapsed acute lymphoblastic leukemia (ALL), there are different types or classifications that can help guide treatment decisions. These classifications are based on factors such as the timing of relapse, the location of relapse, and the response to previous treatments. Here are some common types of relapsed ALL:
1. Early relapse: This refers to a relapse that occurs within 36 months of achieving initial complete remission. Early relapse is generally associated with a poorer prognosis compared to late relapse.
2. Late relapse: Late relapse occurs when leukemia cells reappear more than 36 months after achieving initial complete remission. Late relapse is generally associated with a better prognosis compared to early relapse.
3. Isolated bone marrow relapse: In this type of relapse, leukemia cells are detected only in the bone marrow. This type of relapse is often treated with intensified chemotherapy, targeted therapies, or stem cell transplantation.
4. Central nervous system (CNS) relapse: CNS relapse occurs when leukemia cells are detected in the cerebrospinal fluid or the brain and spinal cord. Treatment for CNS relapse typically involves intrathecal chemotherapy (chemotherapy injected into the cerebrospinal fluid) in addition to systemic therapies.
5. Combined relapse: Combined relapse refers to a relapse that involves both the bone marrow and the central nervous system. Treatment for combined relapse may include intensified chemotherapy, targeted therapies, radiation therapy, and stem cell transplantation.
SYMPTOMS
The symptoms of relapsed acute lymphoblastic leukemia (ALL) can vary from person to person, and they may also depend on the specific type and location of the relapse. Some common symptoms that individuals with relapsed ALL may experience include:
1. Fatigue: Persistent tiredness and lack of energy, which can be more pronounced than usual.
2. Recurrent infections: Increased susceptibility to infections, such as frequent or severe bacterial or viral infections.
3. Bone pain: Pain or discomfort in the bones, particularly in the arms, legs, or back.
4. Enlarged lymph nodes or organs: Swollen lymph nodes or organs, such as the spleen or liver, which may be felt as lumps or cause abdominal pain or fullness.
5. Easy bruising or bleeding: Unexplained bruising, frequent nosebleeds, bleeding gums, or prolonged bleeding from cuts.
6. Shortness of breath: Difficulty breathing or feeling breathless, especially with minimal exertion.
7. Pale skin or easy fatigability: Reduced red blood cell count, leading to anemia, which can manifest as pale skin, weakness, or feeling easily fatigued.
8. Loss of appetite and weight loss: Decreased appetite, unintentional weight loss, or changes in eating patterns.
9. Central nervous system (CNS) symptoms: In cases of CNS relapse, symptoms may include headaches, seizures, dizziness, blurred vision, or changes in behavior or cognition.