From the Guidelines
You should worry about Acute Lymphoblastic Leukemia (ALL) in a 12-month-old if they exhibit symptoms such as pallor, fatigue, or bleeding, as these can be indicative of the disease 1.
Key Considerations
- The age-adjusted incidence rate of ALL in the United States is 1.8 per 100,000 individuals per year, with a median age at diagnosis of 17 years 1.
- ALL represents 75%–80% of acute leukemias among children, making it the most common form of childhood leukemia 1.
- The cure rates and survival outcomes for patients with ALL have improved dramatically over the past several decades, primarily among children, with a 5-year overall survival (OS) rate of 89% for children 1.
- Infants younger than age 1 have a poorer prognosis, with a 6-year OS rate of 58.2% 1.
Risk Factors and Symptoms
- High-risk patients include those with T-ALL, infant ALL, or those who experience relapse 1.
- Symptoms of ALL may include bone or joint pain, weakness, fatigue, or bleeding 1.
- A diagnosis of ALL is typically made through a combination of physical examination, laboratory tests, and imaging studies 1.
Treatment and Management
- Treatment for ALL typically involves multiagent chemotherapy, radiation therapy, and supportive care 1.
- The NCCN Guidelines recommend that patients be treated at a specialized cancer center with expertise in the management of ALL 1.
From the Research
Acute Lymphoblastic Leukemia (ALL) in a 12-month-old
- Acute lymphoblastic leukemia (ALL) is the most common malignancy in children, with a peak incidence between 1 year and 4 years 2.
- At 12 months old, the child is within the age range where ALL is most common, and it is essential to be aware of the signs and symptoms of the disease.
- The survival rates of children with ALL have increased dramatically over the years, with roughly 90% survival rate in trials with risk stratification by biological features of leukaemic cells and response to treatment 3.
Risk Factors and Prognosis
- The prognosis of ALL in children has improved markedly, but some factors can affect the outcome, such as age, leukocyte count, immunophenotype, and genetic abnormalities 4, 3.
- Children with ALL can be stratified into different risk groups based on their biological features and response to treatment, which helps guide treatment decisions and improve outcomes 2, 3.
- Innovative approaches, such as risk stratification, treatment modification, and improved supportive care, have contributed to the improved survival rates in pediatric ALL 3.
Signs and Symptoms
- Although the provided studies do not specifically mention the signs and symptoms of ALL in a 12-month-old, it is essential to consult a healthcare professional if there are any concerns about the child's health.
- A healthcare professional can assess the child's overall health and perform diagnostic tests if necessary to determine if the child has ALL or any other condition.
Treatment and Management
- Treatment for ALL typically involves chemotherapy, and the intensity of the treatment may vary depending on the risk group and response to treatment 4, 2.
- Central nervous system (CNS) prophylaxis is beneficial, particularly for patients with a high risk for CNS relapse, and when introduced early during induction of remission 4.
- Allogeneic bone marrow transplantation (BMT) may be a valuable option for patients with high-risk characteristics or those who have relapsed 4, 5.