Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®): Treatment - Patient Information [NCI] - Risk Groups for Childhood Acute Lymphoblastic Leukemia
Once childhood ALL has been diagnosed, tests are done to find out if the cancer has spread to the brain, spinal cord, testicles, or to other parts of the body.
The following tests and procedures may be used to find out if the cancer has spread:
- Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. The chest x-ray is done to see if leukemia cells are forming a mass in the middle of the chest.
- Testicularbiopsy: The removal of cells or tissues from the testicles so they can be viewed under a microscope by a pathologist to check for signs of cancer. This procedure is done only if there seems to be anything unusual about the testicles during the physical exam.
In childhood ALL, risk groups are used to plan treatment.
Risk groups are described as:
- Standard (low) risk: Includes children aged 1 to younger than 10 years who have a white blood cell count of less than 50,000/µL at diagnosis.
- High risk: Includes children younger than 1 year or 10 years and older and children who have a white blood cell count of 50,000/µL or more at diagnosis.
Other factors that affect the risk group include the following:
- Whether the leukemia cells formed from B lymphocytes or T lymphocytes.
- Whether there are certain changes in the chromosomes of the lymphocytes.
- How quickly the leukemia responds to initial therapy.
- Whether the leukemia has spread to the brain, spinal cord, testicles, or other parts of the body.
It is important to know the risk group in order to plan treatment. Children with high-risk ALL usually receive more aggressive treatment than children with standard-risk ALL.