Acute lymphoblastic leukemia

Harrison, CJ; Johansson, B

doi:10.1002/9781118795569.ch10

Acute lymphoblastic leukemia

Lookup NU author(s): Professor Christine Harrison FRCPath FMedSci

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Abstract

© 2015 John Wiley & Sons, Ltd. Acute lymphoblastic leukemia (ALL) is classified as B-lineage ALL (B-ALL) and T-lineage ALL (T-ALL). The incidence of ALL is almost three times higher in white than black children. Among adults, ALL is more frequent in younger patients, with a median age of less than 30 years. The morphology-immunology-cytogenetics (MIC) subgroups are associated with nonrandom karyotypic abnormalities in a manner comparable to the specificity seen between chromosomal rearrangements and morphologic subgroups in acute myeloid leukemia. Low hyperdiploidy or hypodiploidy with 45 chromosomes and single numerical aberrations are increasingly being found as secondary changes associated with specific structural abnormalities. Cytogenetic analysis plays an integral part in the diagnosis of ALL. The abnormalities differ between B-ALL and T-ALL with different distributions between age groups. In association with these aspects, the diagnostic karyotype is an important prognostic variable. Children with Down syndrome (DS) have a greatly increased risk of developing acute leukemia, including ALL.