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Acute Lymphoblastic Leukaemia

  1. Hisham Morsi1,
  2. Andy Jewell2

Published Online: 5 MAY 2014

DOI: 10.1002/9780470015902.a0002172.pub2

eLS

eLS

How to Cite

Morsi, H. and Jewell, A. 2014. Acute Lymphoblastic Leukaemia. eLS. .

Author Information

  1. 1

    Hamad Medical Corporation, Doha, Qatar

  2. 2

    St George's University of London, London, UK

  1. Based in part on the previous version of this eLS article ‘Acute Lymphoblastic Leukaemia’ (2001) by Judith M Chessells.

Publication History

  1. Published Online: 5 MAY 2014

Abstract

Lymphoblastic leukaemia is a heterogeneous disease of children and adults resulting from clonal expansion of progenitor cells. Treatment with intensive cytotoxic therapy is effective in the majority of children, but treatments for adults are less effective, probably because the disease originates from relatively drug-resistant stem cells. However, treatment of young adults according to paediatric-based regimens has produced superior results to adults-based regimens. Current treatment of children aged between 1 and 10 years has produced a high cure rate of >85% and continues to improve. Not only has survival improved but there are also continuing improvements in reducing toxicity of treatment. This success currently serves as a model for other types of cancer where the cure rate is not yet optimised. The advances of identifying prognostic markers and genome profiling have been instrumental in such successes and will continue serving as landmarks for progress.

Key Concepts:

  • MRD is the most important prognostic factor in ALL patients receiving chemotherapy.

  • Paediatric-based treatment regimens produce superior results to adults-based regimens in treating teenagers and young adults.

  • Febrile neutropenia/susceptibility to infection is a life-threatening complication of chemotherapy that is potentially treatable.

  • The variability in presentation and response to treatment reflects the heterogeneity of acute lymphoblastic leuakaemia.

  • The current success in minimising the morbidity of managing childhood leukaemia serves as a model for other oncological conditions.

Keywords:

  • leukaemia;
  • clinical trials;
  • bone marrow transplantation;
  • molecular genetics;
  • MRD;
  • relapse;
  • immunophenotyping;
  • gene rearrangement;
  • karyotyping