Acute Lymphocytic Leukemia - Complications

Complications

Acute lymphocytic leukemia is responsible for about 1,490 deaths a year in the U.S., and it can progress quickly if untreated. However, ALL is one of the most curable cancers and survival rates are now at an all-time high. Both the oldest and very young age groups tend to have lower survival rates, usually because the leukemia that develops in these patient groups tends to have genetic features that produce a more severe condition.

Outlook in Children with ALL. Survival rates in children with cancer, and leukemia in particular, have increased from 53 - 85% in North America over the past 3 decades.

Certain children are at higher risk for a poor outcome than others:

• African-American and Hispanic children appear to have a poorer outcome than Caucasian children, but this may not be due to biological differences in the response to treatment. A 2003 study found that with equal access to effective therapy, all children can expect the same high rate of cure.
• Survival rates in boys tend to be lower than in girls. The reason for this is not known, although it may be partially due to the boys' higher risks for less favorable genetic profiles and for T-cell ALL.
• Survival rates in infants are improving but they are still poor. The best results are in children ages 1 - 9 years old. Older children may require more aggressive treatment.
• The prognosis may vary depending on other risk factors as well, including the subtype of the cancer, how high the white blood count is, degree of organ involvement, and genetic background.
• Although children with precursor-B and early precursor-B tend to have a better prognosis than patients with the B-cell stage and T-cell types of ALL, advances in treatment are improving the outlook for patients with all these latter types.

Responding well to early treatment is a good sign regardless of the risk category.

Outlook in Adults with ALL. Adults tend to have a more severe condition than children, even if they are carrying the same ALL genes. Between 60 - 80% of adults with ALL can expect to achieve full remission with standard treatments and between 35 - 40% survive beyond 2 years with aggressive treatments. Younger adults with ALL have better long-term survival rates than older adults with the disease.