Acute Lymphoblastic Leukemia (ALL) Questions & Answers

Updated: Jun 20, 2019
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Questions & Answers

Overview

What are the signs and symptoms of acute lymphoblastic leukemia (ALL)?

What is acute lymphoblastic leukemia (ALL)?

Which tests and studies are performed in the evaluation of acute lymphoblastic leukemia (ALL)?

How is the treatment of acute lymphoblastic leukemia (ALL) stratified?

What are the treatment options for treatment of newly-diagnosed acute lymphoblastic leukemia (ALL)?

Which factors require consideration in the treatment selection for acute lymphoblastic leukemia (ALL)?

What is the pathophysiology of acute lymphoblastic leukemia (ALL)?

What causes acute lymphoblastic leukemia (ALL)?

What is the role of an antecedent hematologic disorder (AHD) in the etiology of acute lymphoblastic leukemia (ALL)?

What is the role of genetics in the etiology of acute lymphoblastic leukemia (ALL)?

What is the prevalence of acute lymphoblastic leukemia (ALL)?

What is the prognosis of acute lymphoblastic leukemia (ALL)?

How do tumor markers affect the prognosis of acute lymphoblastic leukemia (ALL)?

How do chromosome abnormalities affect the prognosis of acute lymphoblastic leukemia (ALL)?

What does minimal residual disease (MRD) suggest in the prognosis of acute lymphoblastic leukemia (ALL)?

How do genomic findings affect the prognosis of acute lymphoblastic leukemia (ALL)?

What is included in patient education for acute lymphoblastic leukemia (ALL)?

What are activity and dietary modifications for patients with acute lymphoblastic leukemia (ALL)?

Presentation

What is the presentation of acute lymphoblastic leukemia (ALL)?

What is the most common symptom of acute lymphoblastic leukemia (ALL)?

What are the signs and symptoms of acute lymphoblastic leukemia (ALL)?

What are the symptoms of leukemic cell infiltration of the bone marrow in acute lymphoblastic leukemia (ALL)?

How common is splenomegaly present in suspected acute lymphoblastic leukemia (ALL)?

What are the symptoms of leukostasis in acute lymphoblastic leukemia (ALL)?

What does renal failure indicate in acute lymphoblastic leukemia (ALL)?

What are the physical findings characteristic of acute lymphoblastic leukemia (ALL)?

DDX

How is fever assessed in the evaluation for acute lymphoblastic leukemia (ALL)?

What are the differential diagnoses for Acute Lymphoblastic Leukemia (ALL)?

Workup

Which studies and procedures are performed in the workup of acute lymphoblastic leukemia (ALL)?

What are the National Comprehensive Cancer Network (NCCN) criteria for diagnosis of acute lymphoblastic leukemia (ALL)?

What are the NCCN guidelines for risk stratification and treatment planning in acute lymphoblastic leukemia (ALL)?

What is the role of CBC count in the workup of acute lymphoblastic leukemia (ALL)?

What is the role of coagulation studies and chemistry profiles in the workup of acute lymphoblastic leukemia (ALL)?

What is the role of blood cultures in the workup of acute lymphoblastic leukemia (ALL)?

What is the role of radiography in the workup of acute lymphoblastic leukemia (ALL)?

What is the role of cardiac imaging in the management acute lymphoblastic leukemia (ALL)?

How is a diagnosis of acute lymphoblastic leukemia (ALL) confirmed?

What is the French-American-British (FAB) classification of acute lymphoblastic leukemia (ALL)?

What is the WHO classification of acute lymphoblastic leukemia (ALL)?

How is acute lymphoblastic leukemia (ALL) classified by the WHO?

What is the immunochemistry hallmark finding of acute lymphoblastic leukemia (ALL)?

What is the role of flow cytometry in the workup of acute lymphoblastic leukemia (ALL)?

What is the prevalence of cytogenetic abnormalities in acute lymphoblastic leukemia (ALL)?

What are the distinctions of cytogenetic abnormalities in acute lymphoblastic leukemia (ALL)?

What is the role of polymerase chain reaction (PCR) in the workup of acute lymphoblastic leukemia (ALL)?

Treatment

What type of facility should provide treatment for acute lymphoblastic leukemia (ALL)?

What are the components of acute lymphoblastic leukemia (ALL) treatment?

What commonly used regimens for the treatment of acute lymphoblastic leukemia (ALL)?

When is inpatient treatment indicated for the treatment of acute lymphoblastic leukemia (ALL)?

What are the cure rates for acute lymphoblastic leukemia (ALL)?

What is included in standard induction chemotherapy for acute lymphoblastic leukemia (ALL)?

What is the role of the hyper-CVAD regimen in the treatment of acute lymphoblastic leukemia (ALL)?

What is included in maintenance therapy for acute lymphoblastic leukemia (ALL)?

What are the modified hyper-CVAD regimens for the treatment of acute lymphoblastic leukemia (ALL)?

How does the rapidity of achieving complete remission (CR) affect the prognosis of acute lymphoblastic leukemia (ALL)?

What is the role of rituximab in the treatment of acute lymphoblastic leukemia (ALL)?

What is the efficacy of consolidation chemotherapy in the treatment of acute lymphoblastic leukemia (ALL)?

Which consolidation chemotherapy regimens are used in the treatment of acute lymphoblastic leukemia (ALL)?

What is the efficacy of maintenance chemotherapy for acute lymphoblastic leukemia (ALL)?

What are the benefits of intensive maintenance therapy for acute lymphoblastic leukemia (ALL)?

Why has the prevalence of maintenance therapy for acute lymphoblastic leukemia (ALL) declined?

What is the role of CNS prophylaxis in the treatment of acute lymphoblastic leukemia (ALL)?

What is the prognosis of mature B-cell acute lymphoblastic leukemia (ALL)?

What is the efficacy of treatment for mature B-cell acute lymphoblastic leukemia (ALL)?

How is Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) treated?

What is the role of imatinib in the treatment of Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)?

What is the efficacy of imatinib for the treatment of Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)?

What is the role of nilotinib in the treatment of Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)?

What is the role of dasatinib in the treatment of Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)?

What is the role of dasatinib in the treatment of Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)?

What is the role of ponatinib in the treatment of Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)?

What are the treatment options for older children and younger adults with acute lymphoblastic leukemia (ALL)?

What is the prognosis of with acute lymphoblastic leukemia (ALL) in older children and young adults?

What is the efficacy of specific pediatric regimens in the treatment of older children and young adults with acute lymphoblastic leukemia (ALL)?

What is the efficacy of pediatric regimens for the treatment of adults with acute lymphoblastic leukemia (ALL)?

What is the role of allogeneic transplantation in the treatment of acute lymphoblastic leukemia (ALL)?

What is the efficacy of transplantation for the treatment of acute lymphoblastic leukemia (ALL)?

What are survival rates of acute lymphoblastic leukemia (ALL) following allogeneic bone marrow transplantation (BMT)?

What are survival rates of high-risk acute lymphoblastic leukemia (ALL) following transplantation?

What is the efficacy of allogeneic transplantation for acute lymphoblastic leukemia (ALL) following relapse after chemotherapy?

What is the efficacy of unrelated-donor (URD) transplantation for the treatment of acute lymphoblastic leukemia (ALL)?

What are the survival rates for peripheral-blood stem transplantation for acute lymphoblastic leukemia (ALL)?

What are the treatment options for relapsed acute lymphoblastic leukemia (ALL)?

What is the basis for therapy selection in relapsed acute lymphoblastic leukemia (ALL)?

What standard chemotherapy regimens are used for the treatment of relapsed acute lymphoblastic leukemia (ALL)?

What is the role of clofarabine in the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of nelarabine in the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of vincristine liposomal in the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of blinatumomab (Blincyto) in the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of inotuzumab in the treatment of acute lymphoblastic leukemia (ALL)?

How is gene therapy used to treat acute lymphoblastic leukemia (ALL)?

What is the efficacy of gene therapy for the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of blood products in the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of antibiotics in the treatment of acute lymphoblastic leukemia (ALL)?

What are common prophylactic antibiotic regimens used in the treatment of acute lymphoblastic leukemia (ALL)?

What is the role of granulocyte colony-stimulating factor (G-CSF) in the treatment of acute lymphoblastic leukemia (ALL)?

What is the efficacy of granulocyte colony-stimulating factor (G-CSF) for the treatment of acute lymphoblastic leukemia (ALL)?

What are the benefits of early use of granulocyte colony-stimulating factor (G-CSF) in the treatment of acute lymphoblastic leukemia (ALL)?

What is tumor lysis syndrome in acute lymphoblastic leukemia (ALL)?

How are hyperuricemia and tumor lysis syndrome treated in acute lymphoblastic leukemia (ALL)?

What is included in long-term monitoring of acute lymphoblastic leukemia (ALL)?

Guidelines

Which organizations have issued guidelines for the diagnosis and management of acute lymphoblastic leukemia (ALL)?

What are the College of American Pathologists and the American Society of Hematology (CAP/ASH diagnostic guidelines for acute lymphoblastic leukemia (ALL)?

What are the National Comprehensive Cancer Network (NCCN) diagnostic guidelines for acute lymphoblastic leukemia (ALL)?

What are the National Comprehensive Cancer Network (NCCN) recommendations for the initial workup for acute lymphoblastic leukemia (ALL)?

What are the European Society for Medical Oncology (ESMO) recommendations for the workup for acute lymphoblastic leukemia (ALL)?

What are the NCCN recommendations for first-line treatment of acute lymphoblastic leukemia (ALL)?

What are the American Society for Blood and Marrow Transplantation (ASBMT) guidelines for stem cell transplantation (SCT) in acute lymphoblastic leukemia (ALL)?

Medications

Which medications are used in the treatment of acute lymphoblastic leukemia (ALL)?

Which medications in the drug class Antifungals are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Colony-Stimulating Factors are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Immunomodulators are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Antimicrobials are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class CAR T-Cell Therapies are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Antineoplastic agents, Anti-CD19/CD3 are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Tyrosine Kinase Inhibitors are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Antineoplastics are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Which medications in the drug class Corticosteroids are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?