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Chapter 11
Acute lymphoblastic leukemia and lymphoblastic lymphoma
Acute lymphoblastic leukemia
Acute lymphoblastic leukemia (ALL) is the most common leukemia in children (representing 23% of cancer diagnoses among children younger than 15 years of age) but accounts for only 20% of adult acute leukemias. The prognosis for both childhood and adult ALL has improved remarkably with current intensive induction–consolidation–continuation (maintenance) regimens. In children, treatment now results in complete response (CR) rates of 95% and in 75–85% disease-free survival (DFS) of at least 5 years from diagnosis with current treatments that incorporate systemic therapy and specific central nervous system (CNS) therapy (Gaynon et al., 2000). The use of similar treatment Classification of acute lymphoblastic leukemia Treatment of mature B-cell (Burkitt) ALL in children and adults Treatment of precursor B- and T-cell ALL in children Age at diagnosis White blood cell count at diagnosis Central nervous system status at diagnosis Gender and race Induction therapy Minimal residual disease Gene expression studies Consolidation therapy Central nervous system treatment Maintenance therapy Special groups Relapse Stem cell transplantation Treatment of precursor B- and T-cell ALL in adults Induction phase Minimal residual disease Consolidation therapy CNS prophylaxis Maintenance therapy Philadelphia chromosome-positive ALL Hematopoietic stem cell transplantation in adult ALL First-remission ALL Relapsed disease
Lymphoblastic lymphoma
Late complications of therapy
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