Journal of Leukemia
Open Access

Comparison of Mortality Rate in Adults and Children with Acute Lymphoblastic Leukemia

Takagi Masatoshi^{* *}Correspondence: Takagi Masatoshi, Department of Pediatrics, Tokyo Medical University, Tokyo, Japan, Email:

Author info »

Description

Acute Lymphoblastic Leukemia (ALL) is an antagonistic hematological cancer that affects children and adolescents more often than adults. The survival of ALL has improved, especially in pediatric patients, thanks to the introduction of treatment methods such enhanced chemotherapy, hematopoietic stem cell transplantation, and chimeric antigen receptor-T-cell immunotherapy. The prognosis for adult ALL cases, however, is still not good. A recurrence usually occurs within a few months of Complete Remission (CR) in about 30%-40% adult ALL patients, and about 50% of these patients eventually develop refractory leukemia, which has a dismal prognosis for cure and a 5-year Overall Survival rate (OS) of around 50%. Consequently, treating ALL in adults remains a difficult disease. ALL has been shown to progress due to aberrant genetic mutations and molecular abnormalities that impact cell differentiation, cell proliferation, and treatment resistance. In order to risk stratification and prognosis prediction, several biomarkers with significant roles in molecular etiology and clinical importance were found.

These biomarkers gave possible treatment targets and guided the choice of certain medicines. Notably, the prognosis of ALL patients with BCR -ABL1 transcripts was improved by the use of Tyrosine Kinase Inhibitors (TKI). The detection of genetic abnormalities in ALL, including faulty DNA sequences, aberrant epigenetic changes, and abnormal gene expression, has recently expanded advancements in Next-Generation Sequencing (NGS) technologies including Whole-Exome Sequencing (WES) and RNA sequencing (RNA-seq). The poorer prognosis in ALL was partially caused by the high incidence of genetic subtypes that are unfavorable in adult patients. BCR -ABL1 is a rare disease in childhood (2%-5% of patients), but it affects at least 25% of adults. Older children demonstrated a higher prevalence of somatic mutations and epigenetic regulator mutations than newborns in MLL-rearranged ALL. Additionally, while having the same genetic subtype as pediatric ALL patients, adult patients are less responsive to standard therapy.

These biomarkers gave possible treatment targets and guided the choice of certain medicines. Notably, the prognosis of ALL patients with BCR -ABL1 transcripts was improved by the use of Tyrosine Kinase Inhibitors (TKI). The detection of genetic abnormalities in ALL, including faulty DNA sequences, aberrant epigenetic changes, and abnormal gene expression, has recently expanded advancements in Next-Generation Sequencing (NGS) technologies including Whole-Exome Sequencing (WES) and RNA sequencing (RNA-seq). The poorer prognosis in ALL was partially caused by the high incidence of genetic subtypes that are unfavorable in adult patients. BCR -ABL1 is a rare disease in childhood (2%-5% of patients), but it affects at least 25% of adults. Older children demonstrated a higher prevalence of somatic mutations and epigenetic regulator mutations than newborns in MLL-rearranged ALL. Additionally, while having the same genetic subtype as pediatric ALL patients, adult patients are less responsive to standard therapy.

These biomarkers gave possible treatment targets and guided the choice of certain medicines. Notably, the prognosis of ALL patients with BCR -ABL1 transcripts was improved by the use of Tyrosine Kinase Inhibitors (TKI). The detection of genetic abnormalities in ALL, including faulty DNA sequences, aberrant epigenetic changes, and abnormal gene expression, has recently expanded advancements in Next-Generation Sequencing (NGS) technologies including Whole-Exome Sequencing (WES) and RNA sequencing (RNA-seq). The poorer prognosis in ALL was partially caused by the high incidence of genetic subtypes that are unfavorable in adult patients. BCR -ABL1 is a rare disease in childhood (2%-5% of patients), but it affects at least 25% of adults. Older children demonstrated a higher prevalence of somatic mutations and epigenetic regulator mutations than newborns in MLL-rearranged ALL. Additionally, while having the same genetic subtype as pediatric ALL patients, adult patients are less responsive to standard therapy.