acute lymphoblastic leukaemia

A malignant lymphoproliferative process, which commonly affects children and young adults, affecting ± 1800/year (US); ± 650/year (UK).

Aetiology
ALL has a hereditary component; it is 20-fold increased in patients with Down syndrome; it is linked to benzene exposure, radiation therapy in ankylosing spondylitis.

Clinical findings
Abrupt onset, often ± 3-month history of fatigue, fever, haemorrhage from multiple sites, lymphadenopathy, hepatomegaly, splenomegaly.

Molecular pathology
Most are B cells and express CD19; 60% have karyotypic abnormalities; the most common cytogenetic abnormality is the cryptic t(12;21) translocation, resulting in TEL-AML fusion (25% of cases), followed by the t(1;19)(q23;p13.3) translocation, seen in 5% of cases.

Prognosis
90–95% achieve remission; improved cure rate is attributed to prophylaxis for meningeal leukaemia and more intense systemic chemotherapy. The current survival ranges from 20% to 75%.

FAB classification, acute leukaemias
Acute lymphocytic leukaemia (ALL)
L1—Small monotonous lymphocytes.
L2—Mixed L1- and L3-type lymphocytes.
L3—Large homogeneous blast cells.

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References in periodicals archive

'Specific extra chromosomes occur in a modal number dependent pattern in pediatric acute lymphoblastic leukaemia. Genes Chromosomes Cancer.

A case of hypotriploid chromosome in a patient with acute lymphoblastic leukaemia

Towards an understanding of the biology and targeted treatment of paediatric relapsed acute lymphoblastic leukaemia. British Journal of Haematology, 172(5):655-666.

Potential drug-drug interactions in children with acute lymphoblastic leukaemia: a cohort study

Couban et al., "A multicenter phase II study using a dose intensified pediatric regimen in adults with untreated acute lymphoblastic leukaemia," Blood, vol.

Outcome of adolescents with acute lymphoblastic leukemia treated by pediatrics versus adults protocols

Markers of infection, breast-feeding and childhood acute lymphoblastic leukaemia. Br J Cancer 83:1559-1564.

Infectious etiologies of childhood leukemia: plausibility and challenges to proof

Risk factors for intellectual and educational sequelae of cranial irradiation in childhood acute lymphoblastic leukaemia. Br J Cancer 1996; 73:825-30.

Providing Primary Care for Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia

Treatment of primary refractory and relapsed acute lymphoblastic leukaemia in children and adults: the GIMEMA/ AIEOP experience.

Resultados del tratamiento de leucemia linfoblastica aguda en ninos

The deal between NHS England and Novartis means that the NHS can use Kymriah as a treatment for eligible patients up to the age of 25 who have advanced B-cell acute lymphoblastic leukaemia that is refractory, in relapse post-transplant or in second or later relapse and aren't responding to standard therapies.

NHS funding deal offers children new cancer therapy

Keywords: Acute lymphoblastic leukaemia, Blast cells, Bone marrow, Relapse.

Pattern of relapse in paediatric acute lymphoblastic leukaemia in a tertiary care unit

Diagnosed with acute lymphoblastic leukaemia, a cancer of the white blood cells, he is set to have a bone marrow transplant in the world-renowned Bubble Unit at Newcastle's Royal Victoria Infirmary today.

Relief that this unit is on our doorstep

Five-year-old Nathan Shorey and his family, from Morpeth, were nominated to go on the trip, funded annually by Leukaemia & Lymphoma Research, after Nathan was diagnosed with acute lymphoblastic leukaemia (ALL) in May 2010, aged just two.

Family enjoy Disney trip of a lifetime

One person joining Sir Ian, will be George Jackson, 13, who was 10 years old when he was diagnosed with acute lymphoblastic leukaemia in December 2009.

Beefy to visit Yorkshire