ALL (also called acute lymphocytic leukemia) is an aggressive type of leukemia characterized by the presence of too many lymphoblasts or lymphocytes in the bone marrow and peripheral blood. It can spread to the lymph nodes, spleen, liver, central nervous system (CNS), and other organs. Without treatment, ALL usually progresses quickly.
Signs and symptoms of ALL may include the following:
Weakness or fatigue.
Fever or night sweats.
Bruises or bleeds easily (i.e., bleeding gums,...
Added text to state that the Berlin-Frankfurt-Munster group reported that in pediatric patients with T-cell lymphoblastic lymphoma, loss of heterozygosity at chromosome 6q was observed in 12% of patients and was associated with unfavorable prognosis. NOTCH1 mutations were seen in 60% of patients and were associated with favorable prognosis; NOTCH1 mutations were rarely seen in patients with loss of heterozygosity in 6q16 (cited Bonn et al. as reference 34).
Cellular Classification of Childhood NHL
Added text to state that one study suggested that for children with stage I disease who had a complete resection, a "watch and wait" approach without chemotherapy may be indicated (cited Attarbaschi et al. as reference 54). Also added text to state that patients with higher-stage disease also had a favorable outcome with low- and intermediate-intensity chemotherapy with 94% event-free survival and 100% overall survival, with a 2-year median follow-up; it appears that BCL2-rearrangement negativity and high proliferative index predict favorable disease.
Added Yoon et al. as reference 65.
Treatment Option Overview
Added Galardy et al. as reference 17.
Added text to state that data support that positron emission tomography identifies more abnormalities than computed tomography scanning, but it is unclear whether this should be used to change therapy (cited Cheng et al. as reference 23).
Low-Stage Childhood NHL Treatment
Added text to state that although outcome is generally very good, treatments range from surgery only to multiagent chemotherapy and even autologous blood or marrow transplant. It appears that for pediatric patients without the BCL2 rearrangement and a high proliferative index, surgical resection with no further treatment is sufficient for completely resected, localized disease. For those with tumors that have the BCL2 rearrangement, treatment like that of adult patients with follicular lymphoma is preferred (cited Attarbaschi et. al. as reference 20).