ALL is the most common subtype of leukemia, and the most common type of cancer in children. Also Known as Acute Lymphoblastic Leukemia Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Advancements in technology that enhance our understanding of the biology of the disease, risk-adapted therapy, and enhanced supportive care have contributed to improved survival rates
Pediatric Acute Lymphoblastic Leukemia, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology J Natl Compr Canc Netw . 2020 Jan;18(1):81-112. doi: 10.6004/jnccn.2020.0001 Progress in the understanding and treatment of pediatric acute lymphoblastic leukemia over the past 60 years has been remarkable and it is now expected that 80-85% of children diagnosed will be cured of this disease. This review article discusses risk factors, classification, presentation, risk groups, treatment, outcome, and long-ter
children and 72% of all cases of pediatric leukemia [10,11]. ALL occurs at an annual rate of 3 to 4 cases per 100.000 children less than 15 years of age . Approximately 3,000 children in the United States and 5,000 children in Europe are diagnosed with ALL each year . A sharp peak in incidence is observed among children aged 2 to 5 years . Dworzak,1* Barbara Buldini,2 Giuseppe Gaipa,3 Richard Ratei,4 Ondrej Hrusak,5 Drorit Luria,6 Eti Rosenthal,7 Jean-Pierre Bourquin,8 Mary Sartor,9 Angela Schumich,1 Leonid Karawajew,10 Ester Mejstrikova,5 Oscar Maglia,3. Acute Lymphoblastic Leukemia I page 1 Table of Contents 2 Introduction 2 Here to Help 6 Leukemia 6 Acute Lymphoblastic Leukemia 9 Diagnosis and Cell Classification 13 Treatment 27 Follow-Up Care 29 Research and Clinical Trials 31 Normal Blood and Marrow 34 The Lymphatic System 35 Medical Terms 47 More Information Acknowledgement The Leukemia & Lymphoma Society gratefully acknowledges, for her.
. The search results were narrowed by selecting studies in humans published in English. Clinical trials, practice guidelines, systematic reviews and metaanalysis were evaluated. American Society of Clinical Oncology, American Society o Leukemia is the most common malignancy of childhood, accounting for 30% of cases of childhood cancer. Although there are some associations between environmental or host factors, most leukemia diagnoses in children are sporadic. There are 3 main subtypes of leukemia: acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), and.
Childhood acute lymphoblastic leukemia (ALL) treatment is usually chemotherapy given in phases and determined by risk group. Radiation therapy, targeted therapy and stem cell transplant are sometimes used. Learn more about newly diagnosed and recurrent ALL in this expert reviewed summary Acute lymphocytic leukemia (ALL) is a malignant clonal disease that develops when a lymphoid progenitor cell becomes genetically altered and undergoes uncontrolled proliferation. Early lymphoid precursor cells replace the normal hematopoietic cells of the bone marrow and further infiltrate variou.. Acute Lymphoblastic Leukemia (adult) Acute Lymphoblastic Leukemia (pediatric) Acute Myeloid Leukemia Adolescents and Young Adults with Cancer Anal Cancer Anemia and THE NCCN GUIDELINES AND/OR ANY DERIVATIVE RESOURCES IS EXPECTED TO USE INDEPENDENT MEDICAL JUDGMENT IN THE CONTEXT OF THE INDIVIDUAL CLINICAL CIRCUMSTANCES TO DETERMINE ANY. Acute Lymphoblastic Leukemia (ALL) in Children and Adults April 30, 2019 Speaker Elizabeth Raetz, MD 4 of 79 Slide 5: Leukemia Epidemiology: Children vs. Adults This pie chart here shows the relative frequency of major hematopoietic malignancies in children on the left, compared to that in adults on the right
Surgery for Acute Lymphocytic Leukemia (ALL) Radiation Therapy for Acute Lymphocytic Leukemia (ALL) Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL) Common treatment approaches Treatment of ALL typically lasts for about 2 years. It is often intense, especially in the first few months of treatment, so it's important that you are treated. For acute lymphoblastic leukemia (ALL), the 5-year survival rate has improved significantly since 1975. Get information about risk factors, signs, diagnosis, molecular features, survival, risk-based treatment assignment, and induction and postinduction therapy for children and adolescents with newly diagnosed and recurrent ALL INTRODUCTION. Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed in children. It has an overall survival of approximately 80%, with certain subsets experiencing greater than 98% cure rate. 1 Incremental advances in therapy have led to marked improvements in survival since it was first treated, with these advances highlighting the importance of clinical trials through. Relapse of acute lymphoblastic leukemia References Abstract Acute lymphoblastic leukemia (ALL) is a malignant proliferation of lymphoid cells blocked at an early stage of differentiation and accounts for ¾ of all cases of childhood leukaemia. About 3,000 children in the United States and 5,000 children in Europe are diagnosed with ALL each year
The NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN .® ® NCCN Guidelines Version 1.2014 Updates Acute Lymphoblastic Leukemia UPDATES Summary of changes in the 1.2014 version of the NCCN Guidelines from the 3.2013 version include:Acute Lymphoblastic Leukemia ALL-4 ALL-A ALL. In the run-up to the multinational treatment trial for pediatric acute lymphoblastic leukemia (ALL), jointly designed by the Associazone Italiana Ematologia Oncologia Pediatrica (AIEOP) and the Berlin-Frankfurt-Münster (BFM) group, AIEOP-BFM ALL 2009, the nine involved national FCM reference labs—providing service to an annual recruitment of. We would like to show you a description here but the site won't allow us The National Comprehensive Cancer Network has recently published the first pediatric guidelines for the management of children, adolescent and young adults with acute lymphoblastic leukemia (ALL). The recommendations for diagnosis, work up, genetic evaluation, treatment and follow up of pediatric ALL have been provided
The prognosis for children with acute lymphoblastic leukemia (ALL) has improved dramatically over the past four decades. Breakthroughs in therapy have been achieved in a stepwise fashion through carefully controlled, cooperative group clinical protocols, the hallmark of care within the childhood cancer community Acute lymphoblastic leukemia (ALL) is a malignant (clonal) disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. ALL is the most common type of cancer and leukemia in children in the United States A. Childhood Acute Lymphoblastic Leukemia (ALL) 1. Autologous or allogeneic hematopoietic cell transplantation (HCT) is covered (subject to Administrative Guidelines) to treat childhood ALL in first complete remission but at high risk of relapse. (For definition of high-risk factors, see Policy Guidelines). 2
NCCN Guidelines Version 5.2017 Updates Acute Lymphoblastic Leukemia Updates in Version 3.2017 of the NCCN Guidelines for Acute Lymphoblastic Leukemia from Version 2.2017 include: ALL-9 • Ph-positive ALL: Tisagenlecleucel added as a treatment option for patients ≤25 y and refractory disease or ≥2 relapses and failure of 2 TKIs The understanding of acute lymphoblastic leukemia (ALL) in childhood and adolescence has largely changed due to extensive genetic research in recent years: ALL is now considered to be a very heterogeneous disease group. The leukemia cells present themselves with quite differently activated regulatory mechanisms of the malignant phenotype Acute lymphoblastic leukemia: a comprehensive review and 2017 update T Terwilliger1 and M Abdul-Hay1,2 Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults, with an incidence of over 6500 cases per the pediatric population have identiﬁed genetic syndromes that predispose to a minority of cases of ALL, such. Acute lymphoblastic leukemia (acute lymphocytic leukemia, ALL) is a malignant (clonal) disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. ALL is the most common type of cancer and leukemia in children in the United States. The image below shows B-cell lymphoblastic.
Acute lymphocytic leukaemia (ALL) is a malignant clonal disease that develops when a lymphoid progenitor cell becomes genetically altered and undergoes uncontrolled proliferation. Early lymphoid precursor cells replace the normal haematopoietic cells of the bone marrow and further infiltrate vari.. 201 Pfier nc. All ights eserved. une 201 • Estimated that by 2020, nearly 412,000 people worldwide will be diagnosed with some type of leukemia.2 • ALL accounts for approximately 12% of all leukemia cases worldwide.3 • For adult patients with relapsed or refractory ALL, the five-year overall survival rate is less than 10%.4,5 Acute Lymphoblastic children with acute lymphoblastic leukemia: a report from the children's oncology group. J Clin Oncol. 2012;30(17):2094-2101. 7. Bhatia S, Landier W, Hageman L, et al. 6MP Adherence in a multiracial cohort of children with acute lymphoblastic leukemia: a children's oncology group study. Blood. 2014;124(15):2345-2353. 8 Novel biological subtypes and clinically important genetic aberrations (druggable lesions, prognostic factors) have been described in B-other acute lymphoblastic leukemia (ALL) during the last decade; however, due to a lack of studies on unselected cohorts, their population frequency and mutual associations still have to be established. We studied 110 consecutively diagnosed and uniformly. Leukemia is the most common childhood malignancy and cause of pediatric cancer death. Significant advances in the cure rates of B-cell acute lymphoblastic leukemia (B-ALL) and T-cell acute lymphoblastic leukemia (T-ALL) have been achieved; however, patients with refractory or relapsed B-ALL or T-ALL continue to have poor outcomes
Acute lymphoblastic leukemia. Blast cells on peripheral blood smear or bone marrow aspirate. Children and young adults (53% of new cases occur in persons < 20 years) Symptoms: fever, lethargy. Acute Lymphoblastic Leukemia (ALL) (Part 1 of 12) Note: The National Comprehensive Cancer Network (NCCN) Guidelines® for Acute Lymphoblastic Leukemia (ALL) should be consulted for the management. PURPOSE In the DCOG ALL-11 protocol, polyethylene glycol-conjugated Escherichia coli asparaginase (PEGasparaginase) and Erwinia asparaginase treatment of pediatric acute lymphoblastic leukemia are individualized with therapeutic drug monitoring (TDM). The efficacy of TDM and its effect on asparaginase-associated toxicity are reported. PATIENTS AND METHODS After induction with 3 fixed. Acute lymphoblastic leukemia (ALL), the most common childhood cancer, is a highly curable disease, with approximately 85% of patients being long-term survivors when treated with current chemotherapy regimens. 1 Risk-adapted, intensified chemotherapy regimens have greatly improved the outcome for children, adolescents, and young adults with newly diagnosed B-cell ALL (B-ALL), which comprises.
The outcomes of pediatric acute lymphoblastic leukemia (ALL) have improved remarkably during the last five decades. Such improvements were made possible by the incorporation of new diagnostic technologies, the effective administration of conventional chemotherapeutic agents, and the provision of better supportive care. With the 5-year survival rates now exceeding 90% in high-income countries. Acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL) is the most prevalent cancer among children and adolescents in the United States. Approximately 1/4 of childhood cancers are ALL. 1. Peak age of onset is 3-7 years. 2. A higher frequency of ALL has been reported in industrialized countries and urban areas. 3 Acute Lymphoblastic Leukemia I page 1 Inside This Booklet 2 Introduction 2 Resources and Information 5 Leukemia 6 Acute Lymphoblastic Leukemia 6 Incidence, Causes and Risk Factors 8 Signs and Symptoms 9 Diagnosis and Cell Classification 14 Treatment 29 Follow-Up Care 32 Research and Clinical Trials 34 Normal Blood and Marrow 37 Medical Term Inside This Booklet 2 Introduction 2 Leukemia 4 Acute Lymphoblastic Leukemia 4 Signs and Symptoms 6 Diagnostic Testing 11 Diagnosis and Cell Classification 15 Prognostic Factors/Treatment Planning 17 Treatment 31 Special Treatment Considerations 34 Research and Clinical Trials 36 Related Disease 37 Follow-up Care 40 Incidence, Causes and Risk Factors 41 Normal Blood and Marro Key Points. Question What role does minimal residual disease (MRD) status have in acute lymphoblastic leukemia (ALL)?. Findings We used prospective inclusion criteria to identify 39 studies with 13 637 patients. For both pediatric and adult patients with ALL, MRD negativity was associated with much better long-term outcome. For example, 10-year event-free survival for MRD negativity vs MRD was.
The Turkish Journal of Pediatrics 2006; 48: 1-7 Original Acute and long-term neurologic complications in children with acute lymphoblastic leukemia Selin Aytaç, Sevgi Yetgin, Betül Tavil Division of Pediatric Hematology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey SUMMARY: Aytaç S, Yetgin S, Tavil B. Acute and long-term neurologic complications in. Acute lymphoblastic leukemia (ALL) is the most common cancer among children with 25% chance of disease relapse , while in adults the chance is much higher .According to the cell of origin, ALL can be further subclassified into B-ALL and T-ALL .In clinical, B-ALL accounts for about 80% of pediatric leukemia where it is by far the most common malignancy, with a peak incidence around 2-5. The most common cancer in childhood is now curable in 90% of patients. Current efforts are focused on devising molecular-based therapy for the subsets of acute lymphoblastic leukemia that are most resistant to current therapy Moricke A, Reiter A, Zimmermann M, et al. Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric.
line leukemia treatment in the ICUs in Sweden. Design: A nationwide prospective register and retrospective chart review study. Setting: Children with acute lymphoblastic leukemia were identified,and demographic and clinical data were obtained from the Swedish Childhood Cancer Registry. Data on intensive care were collected from the Swedish Intensive Care Registry. Data on patients with. Childhood acute lymphoblastic leukemia (ALL) is a type of cancer of the blood and bone marrow, and the most common type of cancer in children. In children with this condition, too many stem cells made by the bone marrow become lymphoblasts, B lymphocytes, or T lymphocytes.These cells do not function normally and have trouble fighting off infections. . Signs and symptoms may include fever; easy.
Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000. Leukemia. 2010; 24 (2): 265-284. Google Scholar. Crossref. Search ADS Acute lymphoblastic leukemia (ALL) is the most common cancer in children .Leukemia represents the ninth most common cancer in Brazil and the fifth most frequent in the north region .Advances in cytogenetics and molecular cytogenetics has allowed the identification of genetic aberrations in more than 80% of ALL cases .Establishing genetic background in ALL patients is important for the. Studies have shown the effectiveness of antimicrobial prophylaxis in pediatric acute leukemia and superiority of quinolones over other antibiotics . However, there is no guideline concerning the prophylactic dose of antibiotics. Hence, in most situations therapeutic dose-levels are used [5, 6] . Blinatumomab is a bispecific T-cell-engaging antibody indicated for the treatment of relapsed/refractory acute lymphoblastic leukemia (R/R-ALL). The use of blinatumomab in R/R ALL has shown promising effects.
Unlike pediatric acute lymphoblastic leukemia (ALL), which is curable in > 90% of cases, adult ALL has historically had a dismal prognosis, with limited treatment options and cure rates less than 40% [1, 2], due in part to higher-risk disease features in this population and significant chemotherapy-associated toxicity.B cell ALL accounts for approximately 75% of ALL cases and has historically. An 11-year-old boy with standard-risk pre-B acute lymphoblastic leukemia (diagnosed at 8 years of age) was treated according to Children's Oncology Group protocol AALL0331. Maintenance therapy was well tolerated, with 100% dosing of oral methotrexate, oral 6-mercaptopurine, and oral dexamethasone and intravenous vincristine pulses Learn about treatment options for acute lymphoblastic leukemia (ALL), cancer of the blood and bone marrow. Experienced experts at Seattle Children's provide the most advanced diagnostics and treatments, including next-generation sequencing, targeted therapy, chemotherapy and stem cell transplants Survival for adults and children with acute lymphoblastic leukaemia has risen substantially in recent years because use of improved risk-directed treatments and supportive care has widened. In nearly all developed countries, multidisciplinary panels of leukaemia experts have formulated clinical practice guidelines in which standard treatment approaches are recommended on the basis of current.
Most childhood leukemias are acute: Acute lymphocytic leukemia (ALL), which is the most common type of leukemia in children and the most common cancer in children. In ALL, the bone marrow makes too many lymphocytes, a type of white blood cell. Acute myeloid leukemia (AML), which happens when bone marrow makes abnormal myeloblasts (a type of. The last decade has witnessed great advances in our understanding of the genetic and biological basis of childhood acute lymphoblastic leukemia (ALL), the development of experimental models to probe mechanisms and evaluate new therapies, and the development of more efficacious treatment stratification. Genomic analyses have revolutionized our understanding of the molecular taxonomy of ALL, and. Objective. To evaluate a secondary liver iron overload and its fate in children who are treated conventionally for acute lymphoblastic leukemia and to assess whether serum soluble transferrin receptor (sTfR) is useful in detecting iron load. Methods. Liver siderosis was estimated histologically from liver biopsy specimens of 30 children (aged 2.6-17.6 years) close to or at the end of therapy.
OBJECTIVE. A major reason for poor survival of childhood acute lymphoblastic leukemia in developing countries is treatment refusal or abandonment. This can be associated with parental socioeconomic status and attitudes of health care providers. Our study examined the influence of 2 socioeconomic status determinants, parental income and education, on treatment in an Indonesian academic hospital Email firstname.lastname@example.org. Abstract: Acute lymphoblastic leukemia (ALL) is a heterogenous hematological malignancy representing 25% of all cancers in children less than 15 years of age. Significant improvements in survival and cure rates have been made over the past four decades in pediatric ALL treatment ACUTE LYMP ACUTE LYMPHOBLASTIC LEUKEMIA PEDIATRIC PATIENT Highlights • clonoSEQ Tracking (MRD) testing revealed early signs of relapse post-transplant. • Physician had opportunity to prepare options for follow-up treatment, allowing him to act quickly once relapse was confirmed. ALL Actual results may vary. Limited to one patient case Acute lymphoblastic leukemia (ALL) is the most prevalent cancer among children and adolescents in the United States, representing 20% of all cancers diagnosed in persons aged <20 years, or >3,000 new cases each year (1).Past studies reported increasing trends of ALL overall and among Hispanics, but these represented ≤28% of the U.S. population and did not provide state-based estimates (1-3) Favorable Outcome for Adolescents With Acute Lymphoblastic Leukemia Treated on Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium Protocols Elly Barry, Daniel J. DeAngelo, Donna Neuberg, Kristen Stevenson, Mignon L. Loh, Barbara L. Asselin
INDIAN PEDIATRICS 379 VOLUME 52__MAY 15, 2015 E D I T O R I A LS Nutritional Status and Induction Chemotherapy for Acute Lymphoblastic Leukemia Hemato-Oncologist's Perspective NANDINI C H AZARIKA AND PANKAJ DWIVEDI From Pediatric Oncology Services, Fortis Memorial Research Institute, Gurgaon, Haryana, India. email@example.com The Acute lymphoblastic leukemia (ALL), it produced as a result of a process of malignant transformation of a progenitor lymphocytic cell in the B and T lineages. In ALL, the majority of the cases, the transformation affects the B lineage cells. Leukemia and other cancers share biological characteristics, as clonality Hypodiploidy with less than 45 chromosomes confers adverse risk in childhood acute lymphoblastic leukemia: a report from the Children's Cancer Group Blood , 94 ( 1999 ) , pp. 4036 - 4045 Article Download PDF View Record in Scopus Google Schola The most common cancer in childhood is now curable in 90% of patients. Current efforts are focused on devising molecular-based therapy for the subsets of acute lymphoblastic leukemia that are most.
Leukemia is the most common childhood malignancy, accounting for approximately one third of cancers diagnosed in children, and acute lymphoblastic leukemia (ALL) accounts for over three quarters of all childhood leukemias, with the majority of these being of the precursor B-cell type , Acute lymphocytic leukemia is most common in children, adolescents, and young adults, or those 15 to 39 years of age. ALL is most common in Hispanics and Whites. The rate of new cases of acute lymphocytic leukemia was 1.8 per 100,000 men and women per year based on 2014-2018 cases, age-adjusted
Greaves M. A causal mechanism for childhood acute lymphoblastic leukaemia. Nat Rev Cancer. 2018 May 21.. Nelson R. 'Too Clean' Could Be a Trigger for Childhood Acute Leukemia Acute leukemia is the most common cancer in childhood; in particular, acute lymphoblastic leukemia (ALL) represents roughly up to 80% of all cases of acute leukemias in children. Survival of children with ALL has dramatically improved over the last few decades, and is now over 90% (versus 40% of adult patients) in developed countries, except for in infants (i.e., childre Acute lymphocytic leukemia is the most common childhood malignancy, whereas acute myeloid leukemia primarily affects adults. The underlying cause of acute leukemia is rarely identifiable, but risk factors include prior chemotherapy and radiation therapy , and hereditary syndromes such as Down syndrome The National Comprehensive Cancer Network ® (NCCN ®) has released the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ®) for Pediatric Acute Lymphoblastic Leukemia (ALL)—the most comprehensive and up-to-date evidence-based, consensus-driven guidelines for treating children with cancer outside of a clinical trial setting. These new NCCN Guidelines ® are the first of several. Epidemiologic studies of childhood leukemia have made limited use of tumor genetic characteristics, which may be related to disease etiology. We characterized the cytogenetics of 543 childhood leukemia patients (0-14 years of age) enrolled in the Northern California Childhood Leukemia Study, an approximately population-based study comprised primarily of Hispanics (42%) and non-Hispanic Whites.
Progress in the understanding and treatment of pediatric acute lymphoblastic leukemia over the past 60 years has been remarkable and it is now expected that 80-85% of children diagnosed will be cured of this disease. This review article discusses risk factors, classification, presentation, risk groups, treatment, outcome, and long-term complications of therapy Title:Methotrexate Disposition in Pediatric Patients with Acute Lymphoblastic Leukemia: What Have We Learnt From the Genetic Variants of Drug Transporters VOLUME: 25 ISSUE: 6 Author(s):Ya-Hui Hu, Lin Zhou, Shan-Shan Wang, Xia Jing, Hong-Li Guo, Fang Sun, Yong Zhang, Feng Chen, Jing Xu* and Xing Ji* Affiliation:Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing. ALL is the most common pediatric cancer, and due to the emergence of targeted therapies and immunotherapy, current cure rates are about 90%. The National Comprehensive Cancer Network (NCCN) recently released its first version of the Pediatric Acute Lymphoblastic Leukemia guidelines; these recommendations are categorized by risk level, which can be age related Age at diagnosis is a key prognostic factor in pediatric acute lymphoblastic leukemia (ALL) survivorship. However, literature providing adequate assessment of the survival variability by age at diagnosis is scarce. The aim of this study is to assess the impact of this prognostic factor in pediatric ALL survival. We estimated incidence rate of mortality, 5-year survival rate, Kaplan-Meier. Acute lymphoblastic leukemia (ALL) happens when the body makes too many lymphoblasts (a type of white blood cell). It's the most common type of childhood cancer. ALL is also called acute lymphocytic leukemia and acute lymphoid leukemia. ALL can affect different types of lymphocytes (B-cells or T-cells)
Roberts KG, Pei D, Campana D, et al. Outcomes of children with BCR-ABL1-like acute lymphoblastic leukemia treated with risk-directed therapy based on the levels of minimal residual disease. J Clin. Introduction The objective of this study was to determine the risk factors for childhood acute lymphoblastic leukemia (ALL) and, in particular, the role of parental occupational exposure to carcinogenic and probably carcinogenic hydrocarbons before the child's conception The incidence patterns of childhood acute lymphoblastic leukemia (ALL) differ across ethnic groups but have been studied mostly in populations of predominantly European ancestries. Risk variants identified from previous genome-wide association studies (GWAS) do not fully explain heritable risk. In an effort to address these limitations, we performed a meta-analysis of ALL in 76,317.
Purpose: Adolescent and young adult (AYA) patients (15-39 years old) with acute lymphoblastic leukemia (ALL) have less favorable outcomes and higher treatment-related mortality as compared with older children with ALL. Minimal data exist regarding how well AYA patients tolerate the intensity of chemotherapy at doses and regimens designed for children, and the toxicities suffered by this. Should adolescents with acute lymphoblastic leukemia be treated as old children or young adults? Comparison of the French FRALLE-93 and LALA-94 trials. J Clin Oncol . 2003 Mar 1. 21(5):774-80 Acute Lymphoblastic Leukemia (ALL) is a malignant proliferation of lymphoblasts in the blood and bone marrow. The disease is usually rapidly progressive if untreated. The incidence of ALL peaks in childhood and then remains relatively constant at lower levels throughout adult life. Two-thirds of all ALL cases occur in children, with a peak. Advances in approaches to risk stratification which guide tailored interventions have led to significant improvements in clinical outcomes for pediatric acute lymphoblastic leukemia (ALL). However, many patients relapse and experience multiple relapses Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow. Bone marrow is spongy tissue that fills the cavity of the long bones consisting of fat, red blood cells, and white blood cells. ALL affects the immature white blood cells. Acute leukemia accounts for up to 30% of all childhood malignancies