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Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow. ALL is the most common form of childhood cancer.
Infant ALL occurs in children ages 1 year and younger. ALL in infants is rare. About 90 cases occur each year in the United States.
Infant ALL is different from ALL in older children. Treating cancer in infants is a challenge. Infant ALL is usually aggressive.
Symptoms of relapsed or refractory ALL include:
Diagnosis of infant ALL involves:
More tests will determine the specific kind of ALL. There are 2 main types: B–cell ALL and T–cell ALL. This information will have an impact on treatment approaches.
The main treatment for ALL in infants is chemotherapy with many different medicines. Treatment has different phases. It usually lasts about 2 years.
Medicines used to treat infant ALL may include:
Some patients may receive a stem cell (bone marrow) transplant.
Treatment options may include clinical trials.
Physicians base treatment decisions on the risk of the disease coming back (relapse). Patients with a higher risk of relapse will receive more intensive treatment than those with lower risk.
Most infants have a change in a gene (rearrangement) called MLL (mixed lineage leukemia). Another name for MLL is KMT2A.
When treating infant ALL, physicians consider:
The survival rate for infants with ALL is less than 60%. Infants with the MLL (KMT2A) rearrangement have a high risk of relapse. Most relapses occur within a year of diagnosis.
New insights into the disease show promise in developing new treatments. These include adding immunotherapy and targeted therapy to standard chemotherapy used to treat ALL in infants. Promising new therapies include:
Side effects vary among children. The care team will work with families to try to prevent and lessen side effects. The team will watch closely for side effects and treat them.
Infants are vulnerable to:
Reviewed: December 2022