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

Updated: Feb 20, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Only 20-40% of adults with acute lymphoblastic leukemia (ALL) are cured with current treatment regimens.

Historically, patients with ALL were divided into three prognostic groups: good risk, intermediate risk, and poor risk.

Good risk criteria included the following:

  • No adverse cytogenetics

  • Age younger than 30 years

  • White blood cell (WBC) count of less than 30,000/μL

  • Complete remission within 4 weeks

Intermediate risk included those whose condition did not meet the criteria for either good risk or poor risk.

Poor risk criteria included the following:

  • Adverse cytogenetics – Translocations t(9;22), t(4;11)

  • Age older than 60 years

  • Precursor B-cell WBCs with WBC count greater than 100,000/μL

  • Failure to achieve complete remission within 4 weeks

The addition of tyrosine kinase inhibitors to chemotherapy has resulted in improved prognosis of patients with Philadelphia chromosome–positive ALL such that many no longer consider these patients poor risk. [13]

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