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Acute Lymphoblastic Leukemia - A Comprehensive Review and 2017 Update
Acute Lymphoblastic Leukemia - A Comprehensive Review and 2017 Update
REVIEW
Acute lymphoblastic leukemia: a comprehensive review and
2017 update
T Terwilliger1 and M Abdul-Hay1,2
Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults, with an incidence of over 6500 cases per
year in the United States alone. The hallmark of ALL is chromosomal abnormalities and genetic alterations involved in
differentiation and proliferation of lymphoid precursor cells. In adults, 75% of cases develop from precursors of the B-cell lineage,
with the remainder of cases consisting of malignant T-cell precursors. Traditionally, risk stratification has been based on clinical
factors such age, white blood cell count and response to chemotherapy; however, the identification of recurrent genetic alterations
has helped refine individual prognosis and guide management. Despite advances in management, the backbone of therapy
remains multi-agent chemotherapy with vincristine, corticosteroids and an anthracycline with allogeneic stem cell transplantation
for eligible candidates. Elderly patients are often unable to tolerate such regimens and carry a particularly poor prognosis. Here, we
review the major recent advances in the treatment of ALL.
Blood Cancer Journal (2017) 7, e577; doi:10.1038/bcj.2017.53; published online 30 June 2017
1
New York University School of Medicine, New York, USA and 2Department of Hematology, New York University Perlmutter Cancer Center, New York, USA. Correspondence:
Dr M Abdul-Hay, New York University School of Medicine, 240 East 38th street, 19 Floor, New York 10016, USA.
E-mail: Maher.Abdulhay@nyumc.org
Received 28 March 2017; accepted 21 April 2017
ALL: a comprehensive review and 2017 update
T Terwilliger and M Abdul-Hay
2
Table 1. WHO classification of acute lymphoblastic leukemiaa