Highlights & Basics
- Acute lymphoblastic leukemia (ALL) is a rare hematologic malignancy that develops when a lymphoid progenitor cell undergoes uncontrolled proliferation in the bone marrow, peripheral blood, and/or other organs.
- Most patients have signs and symptoms related to cytopenias (e.g., fatigue, easy bruising) at initial presentation and diagnosis. Enlarged lymph nodes can be an initial presenting sign.
- Physical exam may reveal pallor, ecchymoses, lymphadenopathy, or hepatosplenomegaly. There may be signs of tissue infiltration (e.g., bone pain, testicular enlargement, cranial nerve palsies).
- A definitive diagnosis of ALL requires cytomorphology assessment, immunophenotyping, molecular studies, and cytogenetic analysis of the bone marrow (or peripheral blood if there are sufficient numbers of circulating lymphoblasts).
- Treatment includes the use of chemotherapy-based multiagent therapy, targeted therapy, and immunotherapy in induction, consolidation, and maintenance phases. Allogeneic stem cell transplantation (SCT) is considered in selected patients.
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National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: acute lymphoblastic leukemia [internet publication].[Full Text]
Gökbuget N, Boissel N, Chiaretti S, et al. Diagnosis, prognostic factors, and assessment of ALL in adults: 2024 ELN recommendations from a European expert panel. Blood. 2024 May 9;143(19):1891-902.[Abstract][Full Text]
DuVall AS, McNeer J, Cheung MC, et al. ASH 2026 guidelines for frontline management of acute lymphoblastic leukemia in adolescents and young adults. Blood Adv. 2026 Feb 11:bloodadvances.2021006469.[Abstract][Full Text]
Gökbuget N, Boissel N, Chiaretti S, et al. Management of ALL in adults: 2024 ELN recommendations from a European expert panel. Blood. 2024 May 9;143(19):1903-30.[Abstract][Full Text]
O'Dwyer KM, Winestone LE, Cheung MC, et al. ASH 2026 guidelines for management of relapsed/refractory disease in adolescents and young adults with ALL. Blood Adv. 11 Feb 2026 [Epub ahead of print].[Abstract]
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