Who is at risk for Childhood Acute Lymphoblastic Leukemia? ?
Key Points
                    Past treatment for cancer and certain genetic conditions affect the risk of having childhood ALL. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your child's doctor if you think your child may be at risk.    Possible risk factors for ALL include the following:         - Being exposed to x-rays before birth.    - Being exposed to radiation.    - Past treatment with chemotherapy.    - Having certain genetic conditions, such as:               -  Down syndrome.      -  Neurofibromatosis type 1.      -  Bloom syndrome.      -  Fanconi anemia.      -  Ataxia-telangiectasia.      -  Li-Fraumeni syndrome.      - Constitutional mismatch repair deficiency (mutations in certain genes that stop DNA from repairing itself, which leads to the growth of cancers at an early age).             - Having certain changes in the chromosomes or genes.
                       
                
                    Risk Groups
                    - In childhood ALL, risk groups are used to plan treatment.    - Relapsed childhood ALL is cancer that has come back after it has been treated.
                
                
                
                    In childhood ALL, risk groups are used to plan treatment.
                    There are three risk groups in childhood ALL. They are described as:         - Standard (low) risk: Includes children aged 1 to younger than 10 years who have a white blood cell count of less than 50,000/L at the time of diagnosis.    - High risk: Includes children 10 years and older and/or children who have a white blood cell count of 50,000/L or more at the time of diagnosis.    - Very high risk: Includes children younger than age 1, children with certain changes in the genes, children who have a slow response to initial treatment, and children who have signs of leukemia after the first 4 weeks of treatment.        Other factors that affect the risk group include the following:         - Whether the leukemia cells began from B lymphocytes or T lymphocytes.    - Whether there are certain changes in the chromosomes or genes of the lymphocytes.    - How quickly and how low the leukemia cell count drops after initial treatment.    - Whether leukemia cells are found in the cerebrospinal fluid at the time of diagnosis.        It is important to know the risk group in order to plan treatment. Children with high-risk or very highrisk ALL usually receive more anticancer drugs and/or higher doses of anticancer drugs than children with standard-risk ALL.
                
                
                
                    Relapsed childhood ALL is cancer that has come back after it has been treated.
                    The leukemia may come back in the blood and bone marrow, brain, spinal cord, testicles, or other parts of the body.    Refractory childhood ALL is cancer that does not respond to treatment.