Prior to the development of chemotherapy regimens and hematopoietic stem cell transplant, children were surviving a median length of 3 months, largely due to either infection or bleeding. Since the advent of chemotherapy, the prognosis for childhood leukemia has improved greatly and children with ALL are estimated to have a 95% probability of achieving a successful remission after 4 weeks of initiating treatment. People in pediatric care with ALL in developed countries have a greater than 80% five-year survival rate. It is estimated that 60–80% of adults undergoing induction chemotherapy achieve complete remission after 4 weeks, and those over the age of 70 have a cure rate of 5%. Graphs of overall survival rates at 5 years and 10 years in people in pediatric care and adults with ALL However, there are differing prognoses for ALL among individuals depending on a variety of factors: * Gender: Females tend to fare better than males. * Ethnicity: Caucasians are more likely to develop acute leukemia than African-Americans, Asians, or Hispanics. However, they also tend to have a better prognosis than non-Caucasians. * Age at diagnosis: children 1–10 years of age are most likely to develop ALL and to be cured of it. Cases in older people are more likely to result from chromosomal abnormalities (e.g., the Philadelphia chromosome) that make treatment more difficult and prognoses poorer. Older people are also likely to have co-morbid medical conditions that make it even more difficult to tolerate ALL treatment. * White blood cell count at diagnosis of greater than 30,000 <unk>  or 100,000 (T-ALL) is associated with worse outcomes * Cancer spreading into the Central nervous system (brain or spinal cord) has worse outcomes. * Morphological, immunological, and genetic subtypes * Person's response to initial treatment and longer length of time required (greater than 4 weeks) to reach complete remission * Early relapse of ALL * Minimal residual disease * Genetic disorders, such as Down syndrome, and other chromosomal abnormalities (aneuoploidy and translocations) + In children Factor Unfavorable Favorable Age 10 years 3–5 years Sex Male Female Race Black Caucasian Organomegaly Present Absent Mediastinal mass Present Absent CVS involvement Present Absent Leukocyte count<unk>  >30,000mm3 T-ALL >100,000mm3 Low Hemogblobin concentration >10g/dl 1 week to clear blasts from blood Rapid 4 weeks 50 chromosomes) and t(12;21) are good prognostic factors and also makeup 50% of pediatric ALL cases. + Based on bone marrow cytogenetics Prognosis Cytogenetic findings Favorable Hyperdiploidy > 50 ; t (12;21) Intermediate Hyperdiploidy 47–50; Normal(diploidy); del (6q); Rearrangements of 8q24 Unfavorable Hypodiploidy-near haploidy; Near tetraploidy; del (17p); t (9;22); t (11q23) Unclassified ALL is considered to have an intermediate prognosis risk, somewhere in-between the good and poor risk categories.
Acute lymphoblastic leukemia
Aplastic anemia
Acute myeloid leukemia
Infectious mononucleosis
Prolymphocytic leukemia
Lymphoid leukemia
Myeloid leukemia
Chronic lymphocytic leukemia