The Heterogeneity of Acute Lymphoblastic Leukemia – Complexities of Risk Stratification in ALL

Presentation Description: In the last 20 years technologies have advanced the diagnosis of acute lymphoblastic leukemia (ALL). It has been learned that ALL is a diverse and heterogeneous disease with varying biological features. Today genetic alterations can be found in almost all cases of childhood ALL. These genetic alterations are random and include chromosomal numerical losses or gains, or whole or partial translocations. As the presence of genetic alterations informs both the prognosis and risk assignment of childhood ALL the current standard of care for diagnosis includes a bundle of tests including cytomorphology and cytochemistry with immunophenotyping, cytogenetic analysis and molecular assessment. This spotlight on ALL presentation reviewed both historical and newly discovered ALL biology and describe the increasing complex risk assignment of patients diagnosed with ALL. The presentation also highlighted early precursor T ALL, intrachromosomal amplification of chromosome 21, and an update of Philadelphia positive ALL (t(9:22)) with corresponding influences on current treatment and therapies in development.


Sue Zupanec, MN NP Pediatrics
Nurse Practitioner, Leukemia and Lymphoma Program
The Hospital for Sick Children, Toronto

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