Acute Lymphoblastic Leukemia (ALL) & B-cell Acute Lymphoblastic Leukemia (B-ALL)
Acute Lymphoblastic Leukemia (ALL) and B-cell Lymphoblastic Leukemia (B-ALL) are a heterogeneous hematologic disease characterized by the proliferation of immature lymphoid cells in the bone marrow, peripheral blood, and other organs. The increase and accumulation of blast cells in the bone marrow results in suppression of the normal production of blood cell and blood plasma components, and can therefore cause anemia, thrombocytopenia, neutropenia and risk of infection. ALL can start either with early B-cells or T-cells at different stages of maturity. The American Cancer Society’s estimates for ALL in the United States for 2019 (including both children and adults) are about 5,930 new cases of ALL and about 1,500 deaths. Approximately 85% of ALL cases involve precursor B-cells (B-ALL).
The risk for developing ALL is highest in children younger than 5 years of age, but declines over time until the mid-20s, and increases again slowly after age 50. Overall, about 4 of every 10 cases of ALL are in adults. The cure rates and survival outcomes for patients with ALL have improved dramatically over the past several decades, primarily among children. Improvements are largely owed to advances in the understanding of the molecular genetics and pathogenesis of the disease, the incorporation of risk-adapted therapy, and the advent of new, targeted agents. Despite great progress in the development of curative therapies, ALL remains a leading cause of pediatric cancer-related mortality for patients presenting with a relapsed or refractory disease. New therapies are needed to overcome chemotherapy resistance and reduce non-specific treatment associated side effects.