Noteworthy Numbers: Acute Lymphocytic Leukemia

TON - February 2020, Vol 13, No 1

Leukemia is the most frequently diagnosed cancer in children and adolescents, representing approximately 1 of 3 cancers in these populations of patients. Of the 4 main types of leukemia (acute myeloid leukemia, acute lymphocytic leukemia [ALL], chronic myeloid leukemia, and chronic lymphocytic leukemia), ALL is the most common type found in children and adolescents. The following provides key statistics and other helpful information regarding ALL.

The American Cancer Society estimates that approximately 6150 new cases of ALL will be diagnosed in the United States in 2020, and approximately 1520 deaths will be attributed to the disease in the same year. Although most cases of ALL occur in children, 4 of 5 deaths related to the disease occur in adults.1

The National Cancer Institute reports that the overall incidence of pediatric cancer, including ALL, has been slowly on the rise since 1975.2 Incidence peaks sharply in young children (>90 cases per 1 million per year in those aged 2 to 3 years vs <30 cases per 1 million by age 8 years). The incidence of ALL is highest in Hispanic children and is considerably higher in white children than in African-American children.2 Overall, ALL represents approximately 25% of all cancers found in children and teens aged <15 years.2

Children with Down syndrome have a 10- to 20-fold increased risk for developing acute leukemia, and Down syndrome is among the strongest risk factors for developing ALL, as well as acute myelogenous leukemia.3 Approximately 50% to 60% of children with ALL and Down syndrome have genomic alterations affecting the CRLF2 gene, resulting in an overexpression of the gene’s protein.2 In 35% of these patients, the IKZF1 gene deletions are associated with worse outcomes.2

Overall, the 5-year survival rate for children diagnosed with ALL is 91%.4 Approximately 98% of children with ALL will achieve remission, and approximately 85% of children aged 1 to 8 years with newly diagnosed ALL are expected to be long-term, event-free survivors.2 Children diagnosed with ALL who remain disease free for ≥5 years are considered “cured” because it is rare for acute leukemia to recur after that time.2

References

  1. American Cancer Society. Key statistics for acute lymphocytic leukemia (ALL). Updated January 8, 2020. www.cancer.org/cancer/acute-lymphocytic-leukemia/about/key-statistics.html. Accessed January 23, 2020.
  2. National Cancer Institute. Childhood acute lymphoblastic leukemia treatment (PDQ)-health professional version. Updated October 22, 2019. www.cancer.gov/types/leukemia/hp/child-all-treatment-pdq. Accessed January 24, 2020.
  3. Matloub Y, Rabin KR, Ji L, et al. Excellent long-term survival of children with Down syndrome and standard-risk ALL: a report from the Children’s Oncology Group. Blood Adv. 2019;3:1647-1656.
  4. Cancer.Net. Leukemia - acute lymphoblastic - ALL - childhood - introduction. www.cancer.net/cancer-types/leukemia-acute-lymphoblastic-all-childhood/view-all. Accessed January 24, 2020.

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