Acute Lymphoblastic Leukemia: Prognosis, Risk Factors, and Survival Rates in Pediatric and Adult Patients

Acute lymphoblastic leukemia (ALL) is a hematological neoplasm that affects both children and adults, although its incidence is higher in the pediatric population. This disease is characterized by the uncontrolled proliferation of lymphoblasts in the bone marrow, which interferes with the normal production of blood cells. Over the years, significant advances have been made in the treatment and prognosis of acute lymphoblastic leukemia, especially in children, where survival rates have improved remarkably.

Diving into Prognosis and Risk Factors

The prognosis of ALL varies considerably between children and adults. In the pediatric population, survival rates have reached approximately 90% thanks to risk stratification based on biological characteristics of leukemic cells and treatment response. However, in adults, the prognosis remains less favorable, with long-term survival rates of around 50% in some subtypes of ALL [1].

Prognostic factors influencing the prognosis include the patient's age, white blood cell count at diagnosis, the presence of extramedullary disease, immunophenotype, and cytogenetic abnormalities. Minimal residual disease (MRD) is a crucial marker that guides therapeutic decisions and is strongly associated with treatment outcomes [2].

In recent years, treatment regimens inspired by pediatric protocols have been developed for adolescents and young adults, improving survival rates in these groups [3]. Additionally, the incorporation of targeted therapies and immunotherapy has shown promising results in the treatment of refractory or relapsed ALL [4].

Conclusions

Despite advances in the treatment of ALL, there remains an urgent need to improve outcomes in adults and in high-risk cases. Ongoing research in identifying prognostic markers and developing personalized therapies is essential to enhance ALL life expectancy. The integration of new therapeutic strategies, such as immunotherapy, offers a promising avenue to increase acute leukemia survival rates and reduce the adverse effects of conventional treatment.

Referencias

• [1] Acute lymphoblastic leukaemia
• [2] Minimal Residual Disease Assessment and Risk-based Therapy in Acute Lymphoblastic Leukemia
• [3] Pegaspargase-modified risk-oriented program for adult acute lymphoblastic leukemia
• [4] Prediction of Response to FDA-Approved Targeted Therapy and Immunotherapy in Acute Lymphoblastic Leukemia (ALL)

Created 14/1/2025