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Review Article Open Access
Acute lymphoblastic leukemia is a type of leukemia which is characterized by 20% or more lymphoblasts in the bone marrow and/or the blood. It is a rapidly developing, abnormal growth of the cells that are precursors of lymphoblasts. The peak incidence occurs between age 2 and 5 years. The most frequent signs are lymphadenopathies, hepatosplenomegaly, fever, anemia, signs of hemorrhage, and bone tenderness. Biological findings include hyperleukocytosis due to circulating lymphoblasts. Most of the cases of acute lymphoblastic leukemia show chromosomal and genetic abnormalities. These anomalies occur spontaneously in important regulatory genes in a lymphoid cell population. The causative factors may be like smoking, high birth weight, diet, and high socioeconomic status, electromagnetic field, being exposed to radiation, pesticides, past treatment with chemotherapy or other drugs that weaken the immune system. It is a biologically heterogeneous disorder, so that morphologic, immunologic, cytogenetic, and molecular genetic characterizations of leukemia lymphoblasts are needed to establish the diagnosis or to exclude other possible causes of bone marrow failure and, finally, to classify its subtypes. The survival rate for children younger than 15 years of age reaches about 75%, but, despite the significant improvement of outcome during the last decades, still roughly 25% of patients suffer from a relapse of the disease. With the need to stratify patients in risk groups and to provide risk-adapted therapy, treatment requires high levels of organization, expertise and knowledge.
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Author(s): Neelkamal,Radha Rathee