Treatment Plans by Risk Group
In childhood ALL, risk groups are used to plan treatment.
There are two 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 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 diagnosis.
Other factors that affect the risk group include the following:
- Whether the leukemia cells began from B lymphocytes or T lymphocytes.
- Whether there are certain changes in the chromosomes or genes of the lymphocytes.
- How quickly and how low the leukemia cell count drops after initial treatment.
- Whether leukemia cells are found in the cerebrospinal fluid at diagnosis.
It is important to know the risk group in order to plan treatment. Children with high-risk ALL usually receive more anticancer drugs and higher doses of anticancer drugs than children with standard-risk ALL.
Treatments by Risk Group
The treatment of standard-risk childhood acute lymphoblastic leukemia (ALL) during all phases always includes combination chemotherapy. When children are in remission after remission induction therapy, a stem cell transplant using stem cells from a donor may be done. When children are not in remission after remission induction therapy, further treatment is usually the same treatment given to children with high-risk ALL.
The treatment of high-risk childhood acute lymphoblastic leukemia (ALL) during all phases always includes combination chemotherapy. Children in the high-risk ALL group are given more anticancer drugs and higher doses of anticancer drugs, especially during the consolidation/intensification phase, than children in the standard-risk group. Intrathecal and systemic chemotherapy are given to prevent or treat the spread of leukemia cells to the brain and spinal cord. Sometimes radiation therapy to the brain is also given.
Adapted from the National Cancer Institute’s Physician Data Query (PDQ(r)) Cancer Information Summaries (http://www.cancer.gov/
For more information:
Go to the Childhood Leukemia health topic.