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

Updated: Jul 02, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

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 experts no longer consider these patients poor risk. [13]


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