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Risk Groups for Childhood Acute Lymphoblastic Leukemia

Key Points

  • In childhood ALL, risk groups are used to plan treatment.
  • Relapsed childhood ALL is cancer that has come back after it has been treated.

In childhood ALL, risk groups are used to plan treatment.

There are three risk groups in childhood ALL. They 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 the time of diagnosis.
  • High risk: Includes children 10 years and older and/or children who have a white blood cell count of 50,000/µL or more at the time of diagnosis.
  • Very high risk: Includes children younger than age 1, children with certain changes in the genes, children who have a slow response to initial treatment, and children who have signs of leukemia after the first 4 weeks of treatment.

Other factors that affect the risk group include the following:

It is important to know the risk group in order to plan treatment. Children with high-risk or very high–risk ALL usually receive more anticancer drugs and/or higher doses of anticancer drugs than children with standard-risk ALL.

Relapsed childhood ALL is cancer that has come back after it has been treated.

The leukemia may come back in the blood and bone marrow, brain, spinal cord, testicles, or other parts of the body.

Refractory childhood ALL is cancer that does not respond to treatment.


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