Discussion of Childhood Acute Lymphoblastic Leukemia

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Discussion of Childhood Acute Lymphoblastic Leukemia

Worldwide, Acute Lymphoblastic Leukemia (ALL) is one of the most common childhood malignancies. Approximately 75% of childhood leukemias are ALL; B-cell ALL is more common and more favorable prognostically than T-cell ALL. Overall, the long-term survival rate (survival past 5 years after diagnosis) for childhood ALL is very high, approximately 80–90%.
Favorable risk factors include:
  • age <10 years old
  • white blood cell count (WBC) less than 50 x 109 /L
  • female gender
  • B-ALL
  • t(12;21) with ETV6-RUNX1 gene fusion
  • high hyperdiploidy
  • rapid time to complete remission after treatment
Poor risk factors include:
  • age >16 years
  • white blood cell count (WBC) greater than 50 x 109 /L
  • male gender
  • T-ALL
  • hypodiploidy
  • Philadelphia chromosome t(9;22)
  • intrachromosomal amplification of chromosome 21
These are just a few examples. The complete diagnosis and treatment for ALL are so complex that clinicians must consider various biomarkers and other factors.