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Symptoms and Staging for ALL

Signs and Symptoms

  • Weakness or fatigue.
  • Fever or night sweats.
  • Bruises or bleeds easily (i.e., bleeding gums, purplish patches in the skin, or petechiae [flat, pinpoint spots under the skin]).
  • Shortness of breath.
  • Unexpected weight loss or anorexia.
  • Pain in the bones or joints.
  • Swollen lymph nodes, particularly lymph nodes in the neck, armpit, or groin, which are usually painless.
  • Swelling or discomfort in the abdomen.
  • Frequent infections.



There is no clear-cut staging system for this disease. This disease is classified as untreated, in remission, or recurrent.

Untreated Adult ALL

For a newly diagnosed patient with no prior treatment, untreated adult acute lymphoblastic leukemia (ALL) is defined by the following:

  • Abnormal white blood cell count and differential.
  • Abnormal hematocrit/hemoglobin and platelet counts.
  • Abnormal bone marrow with more than 5% blasts.
  • Signs and symptoms of the disease.

Adult ALL in Remission

A patient who has received remission-induction treatment of ALL is in remission if all of the following criteria are met:

  • Bone marrow is normocellular with no more than 5% blasts.
  • There are no signs or symptoms of the disease.
  • There are no signs or symptoms of central nervous system leukemia or other extramedullary infiltration.
  • All of the following laboratory values are within normal limits:

    • White blood cell count and differential.
    • Hematocrit/hemoglobin level.
    • Platelet count.


Adapted from the National Cancer Institute’s Physician Data Query (PDQ(r)) Cancer Information Summaries ( Date last modified: April 17, 2015

For more information:

Go to the Adult Leukemia health topic.