This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Friedmann, A. M. Articles by Weinstein, H. J. Search for Related Content PubMed PubMed Citation Articles by Friedmann, A. M. Articles by Weinstein, H. J.

The Role of Prognostic Features in the Treatment of Childhood Acute Lymphoblastic Leukemia

Massachusetts General Hospital, Division of Pediatric Hematology/Oncology, Boston, Massachusetts, USA

Correspondence: Alison M. Friedmann, M.D., M.Sc., Massachusetts General Hospital, Pediatric Hematology/Oncology Unit, Blake 255, 55 Fruit Street, Boston, Massachusetts 02114, USA. Telephone: 617-726-2737; Fax: 617-724-0702; e-mail: afriedmann{at}partners.org

Acute lymphoblastic leukemia (ALL) is the most common cancer in children and is among the most curable of the pediatric malignancies. Many clinical, biological, genetic, and molecular features have been identified as having prognostic significance in the outcome of patients with ALL. The standard features are age and WBC at diagnosis, with infants (less than one year), adolescents (greater than nine years), and children with WBC above 50,000/µl being at higher risk. Certain chromosomal abnormalities are also strong predictors; in particular, the Philadelphia chromosome and MLL gene rearrangements (especially in infants) are adverse features, while TEL-AML1 is favorable. It is important to note, however, that even the most important known predictors explain only a small proportion of the variability in outcome. These features are currently used to tailor the intensity of treatment so that the toxicity of treatment can be minimized and cure rates can continue to improve. This article reviews time-honored prognostic features, recent advances, and future directions in this field.

Key Words. Acute lymphoblastic leukemia • Pediatric • Childhood • Prognostic factors • Treatment

This article has been cited by other articles:

				M. S. Huang and R. P. Hasserjian Case 19-2004 - A 12-Year-Old Boy with Fatigue and Eosinophilia N. Engl. J. Med., June 17, 2004; 350(25): 2604 - 2612. [Full Text] [PDF]

				M. E. Ross, X. Zhou, G. Song, S. A. Shurtleff, K. Girtman, W. K. Williams, H.-C. Liu, R. Mahfouz, S. C. Raimondi, N. Lenny, et al. Classification of pediatric acute lymphoblastic leukemia by gene expression profiling Blood, October 15, 2003; 102(8): 2951 - 2959. [Abstract] [Full Text] [PDF]

				A. L. Nashed, K. W. Rao, and M. L. Gulley Clinical Applications of BCR-ABL Molecular Testing in Acute Leukemia J. Mol. Diagn., May 1, 2003; 5(2): 63 - 72. [Abstract] [Full Text] [PDF]

				M. Hotfilder, S. Rottgers, A. Rosemann, H. Jurgens, J. Harbott, and J. Vormoor Immature CD34+CD19- progenitor/stem cells in TEL/AML1-positive acute lymphoblastic leukemia are genetically and functionally normal Blood, June 28, 2002; 100(2): 640 - 646. [Abstract] [Full Text] [PDF]