In a nutshell
These guidelines aimed to provide information on managing acute lymphoblastic leukemia in pediatric patients.
Acute lymphoblastic leukemia (ALL) is the most common cancer in pediatric patients. Advancements in technology have led to improved survival rates for these patients.
The National Comprehensive Cancer Network (NCCN) guidelines for pediatric ALL patients focus on workup, diagnostic evaluation, and treatment of the disease. It is important to provide the most recent advancements on the frontline and relapsed/refractory management of pediatric ALL.
Methods & findings
Workup for suspected ALL consists of a full medical history and physical examination. It also consists of laboratory studies of blood count levels and other levels. A diagnosis of ALL can be reached if there are 20% or more bone marrow lymphoblastic (immature white cells) in the bone marrow. Sub-types of ALL can be classified by genetic abnormalities.
Treatment of ALL can be broken into three phases: induction, consolidation, and maintenance. All treatment regimens for ALL include brain prophylaxis and/or treatment. Brain prophylaxis is used as a preventative treatment. It kills cancer cells that may be in the brain and spinal cord even though no cancer has been detected there.
Some treatment plans may include chemotherapy, targeted therapies and hemopoietic stem cell transplant (HSCT). HSCT involves taking cells from a donor and transplanting to the patient to replace healthy cells damaged by previous treatment.
Minimal residual disease (MRD) is the small number of cancer cells that remain after treatment. MRD can be used to determine how successful a treatment was. MRD testing is an essential part of patient evaluation and disease management in pediatric ALL.
The bottom line
These guidelines reviewed current practices in the diagnosis and management of pediatric ALL.
Published By :
Journal of the National Comprehensive Cancer Network
Jan 01, 2020