Acute Lymphoblastic Leukemia

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Acute lymphoblastic leukemia (ALL) is a malignant disorder of lymphoid progenitor cells, affecting both children and adults. The disease peaks between the ages of 2-5years with an incidence of 3-4/100,000 in patients between 0-14 years and 1/100,000 in those over 15 years. ALL is believed to originate from genetic aberrations in blood progenitor cells that will differentiate into T-cells or B-cells. The events leading up to the development of ALL are largely unknown, however some environmental and genetic factors have been linked. Less than 5% appear to be associated with inherited genetic syndromes. Environmental factors such as exposure to ionizing radiation and/or chemotherapeutic drugs in utero, pesticides and solvents appear to increase the risk of leukemia.

ALL can be divided into several categories according to phenotype. B-ALL (BCP-ALL) is a malignancy of lymphoblasts that are of B-cell lineage which is the main disease seen in children. T-ALL is seen in approximately 15% of children and 25% of adults. ALL can be further classified using the FAB classification representing cytomorphological features (L1-L3) and also immunophenotypic features which are the expression of cell specific antigens.

ALL has a good prognosis for pediatric patients with overall survival of 80%. Unfortunately, adult sufferers have a high remission rate but lower overall survival of 40-50%. Age, leucocyte count, ethnicity, weight and genetic factors play a role in risk stratifying patients. Treatment usually consists of remission-induction phase, intensification phase and continuation therapy, with an additional focus on the central nervous system to prevent relapse.

Conferences

IACH 2021
SOHO 2021
EHA 2021
ESH ALL 2021
EBMT 2021
TCT 2021

Topics

Transplant
CAR-T & Cellular Therapy
MRD
Immuno-Oncology
Trial Updates
Treatment

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