ALL is primarily a disease of childhood, with 75% of cases occurring in children under the age of 10 years at diagnosis. However, although ALL is rare in adults, there is an increasing incidence with age after the age of 40 years. Eighty – five percent of cases are of B– cell lineage and have an equal sex incidence; there is a male predominance for the 15% of T - cell ALL.1
The clinical presentation of ALL is nonspecific, and thus, patients may present with “B symptoms", infection, easy bruising / bleeding, dyspnea, and fatigue.2
The diagnosis of ALL requires the presence of 20% or more lymphoblasts in the bonemarrow. Further assessment by flow cytometry, morphological studies, immunophenotyping, and cytogenetic testing is important.
The primary goal of induction therapy is complete eradication of lymphoblasts from the blood, bone marrow, CNS and other extramedullary sites when initially involved. Complete remission (CR) is currently defined on a morphological basis of less than 5% blasts in the bone marrow in the presence of over allhaematological recovery (neutrophils > 1.0 × 109 /L, platelets > 100 ×
109/L).3