Confirmed Diagnosis

Mom has Acute Lymphocytic Leukemia. It's not good. Here are the details:

Acute Lymphocytic Leukemia (ALL)

ALL is the most common pediatric cancer; it also strikes adults of all ages. Malignant transformation and uncontrolled proliferation of an abnormally differentiated, long-lived hematopoietic progenitor cell results in a high circulating number of blasts, replacement of normal marrow by malignant cells, and the potential for leukemic infiltration of the CNS and abdominal organs. Symptoms include fatigue, pallor, infection, and easy bruising and bleeding. Examination of peripheral smear and bone marrow is usually diagnostic. Treatment typically includes combination chemotherapy to achieve remission, intrathecal chemotherapy for CNS prophylaxis and/or cerebral irradiation for intracerebral leukemic infiltration, consolidation chemotherapy with or without stem cell transplantation, and maintenance chemotherapy for 1 to 3 yr to avoid relapse.

Two thirds of all ALL cases occur in children, with a peak incidence at age 2 to 5 yr; ALL is the most common cancer in children and the 2nd most common cause of death in children < age 15. A 2nd rise in incidence occurs after age 45.

Prognosis
Prognostic factors help determine treatment protocol and intensity.

Favorable prognostic factors are
· Age 3 to 7 yr
· WBC count < 25,000/μL
· French-American-British (FAB) L1 morphology
· Leukemic cell karyotype with > 50 chromosomes and t(12;21)
· No CNS disease at diagnosis

Unfavorable factors are
· A leukemic cell karyotype with chromosomes that are normal in number but abnormal in morphology (pseudodiploid)
· Presence of the Philadelphia (Ph) chromosome t(9;22)
*** waiting for results on this***
· Increased age in adults
· B-cell immunophenotype with surface or cytoplasmic immunoglobulin

Regardless of prognostic factors, the likelihood of initial remission is ≥ 95% in children and 70 to 90% in adults. About 75% of children and 30 to 40% of adults have continuous disease-free survival for 5 yr and appear cured. Imatinib Some Trade Names GLEEVECClick for Drug Monograph improves outcome in patients with Ph chromosome–positive ALL. Most investigatory protocols select patients with poor prognostic factors for more intense therapy, because the increased risk of and toxicity from treatment are outweighed by the greater risk of treatment failure leading to death.

Treatment
· Chemotherapy
· Sometimes stem cell transplantation or radiation therapy

The 4 general phases of chemotherapy for ALL include
· Remission induction
· CNS prophylaxis
· Postremission consolidation or intensification
· Maintenance