HIGH RISK
Children who have any of the following factors are considered high risk: children older than 1 year and younger than 10 years with a WBC greater than 50,000 at diagnosis children 10 years or older, regardless of WBC count have testicular disease have leukemia in their spinal fluid at diagnosis, called CNS-3 leukemia cells with certain chromosome abnormalities (such as Philadelphia chromosome ALL [also called BCR-ABL] or MLL gene rearrangement) children who were treated with steroids before the diagnosis of ALL was made last day of induction therapy MRD greater or equal to 0.01%.
VERY HIGH RISK
do not have Down syndrome have a chromosome abnormality: iAMP21, MLL rearrangement, hypodiploidy (< 44 chromosomes or DNA index of < 0.81)
not in remission by the last day of induction, MRD > 0.01% unfavorable cytogenetics with Day 29 MRD of > 0.01%.
It is important to determine your child’s risk group so the treatment team can determine the chance for a cure. Because ALL is a cancer of the blood-forming cells in the bone marrow, treatment involves the blood system and entire body. All types of B-cell and T-cell ALL are commonly treated with chemotherapy and sometimes with radiation therapy. Your healthcare team will discuss with you the recommended treatment plan based on your child’s risk group.
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Association of Pediatric Hematology/Oncology Nurses (APHON)
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