Pediatric Acute Lymphoblastic Leukemia

Pediatric Acute Lymphoblastic Leukemia (ALL), is the most common type of cancer that affects the blood and bone marrow of children, accounting for about 75-80% of all childhood leukemia cases.

Causes

The majority of Pediatric ALL are of B-cell lineage and a small proportion of T-Cell Lineage. Another subtype within this is presence of Philadelphia Chromosome (t 9;22). 

The exact cause of childhood ALL is often unknown, but certain genetic and environmental factors can contribute to its development. Some risk factors for childhood ALL include exposure to high levels of radiation, certain genetic conditions (such as Down syndrome), and exposure to certain chemicals or toxins.

Symptoms

The symptoms of childhood ALL can vary, but common signs may include:

  • Fatigue and Weakness
  • Frequent infections
  • Unexplained bruising or bleeding
  • Enlarged lymph nodes, neck, underarm, stomach, or groin
  • Bone or joint pain
  • Loss of appetite and weight loss
  • Shortness of breath
  • Pale skin or anemia

Diagnosis is usually made through a combination of blood tests, bone marrow aspiration and biopsy, and other imaging studies. If childhood ALL is confirmed, further tests will be done to determine the subtype of ALL and the risk level, which helps guide treatment decisions. Please check with your doctor for further information.

What are the Treatment Options for Pediatric ALL ?

Depends on the child's age, subtype of ALL, risk factors, and other individual factors.

01

Chemotherapy

Chemotherapy are drugs used to stop the growth of cancer cells. It is achieved either by killing the cells or by stopping them from dividing. Chemotherapy can be taken orally or injected into a vein or muscle.

02

Radiation Therapy

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells, hence, limiting their growth. It may also be used to prepare the hematopoietic stem cell transplantation also.

03

Hematopoietic stem cell transplantation

It is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of a donor and are frozen and stored. These stem cells grow into and restore the body's blood cells

04

Targeted therapy

Targeted therapy are drugs which identify and attack specific cancer cells - Tyrosine kinase inhibitor (TKIs) therapy, Monoclonal antibodies and Proteasome inhibitor therapy

05

Immunotherapy

Immunotherapy is a treatment that uses the patient’s immune system to fight cancer. This cancer treatment is a type of biologic therapy.

06

CAR-T cell therapy

Chimeric antigen receptor (CAR) T-cell therapy is a novel treatment to fight some cancers including Pediatric B-ALL. It involves using your body’s own immune system to treat your cancer.

Please talk to your doctor about the right treatment option for you or your loved one.

Know More About CAR-T Cell Therapy

CAR T-cell therapy is a novel treatment to fight some cancers. It involves using your body's own immune system to treat your cancer. CD-19 CAR T-cell therapy has been a standard of care for Relapsed/Refractory B-cell Malignancies in the West since 2017. Based on the recently published evidence, CD-19 targeted CAR T-cell therapy is now the preferred second line therapy for some sub types of B-cell Malignancies.

Explore More

Have a Question?

Our experienced team is ready to provide you with the support and guidance you need to make informed decisions about personalized cell and gene therapies.

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References

  1. Caballero-Baños M, Delgado J, Rives S, et al. Production of ARI-0001 cells (A3B1:CD8:4-1BB:CD3z CAR19 cells) in patients with CD19+ relapsed/refractory B-cell malignancies using the CliniMACS Prodigy System. Abstract PF405 EHA Annual Meeting 2018
  2. Delgado J, Rives S, Castella M, et al. CART19-BE-01: A European Academic Trial on The Use Of ARI-0001 Cells (A3B1:CD8:4-1BB:CD3Z CAR19 CELLS) in Patients with CD19+ Relapsed/Refractory Acute Lymphoblastic Leukemia. Abstract S835; EHA Annual Meeting 2018.
  3. Ortiz-Maldonado V, Caballero-Baños M, Bataller A, et al. Significant ARI-0001 (A3B1:CD8:4-1BB:CD3Z CAR19) Cell Expansion In A Patient With Refractory Chronic Lymphocytic Leukemia Through Pre-Lymphoapheresis Ibrutinib Administration. Abstract PS1153; EHA Annual Meeting 2018.
  4. Ortiz-Maldonado M, Alonso-Saladrigues A, Cardozo C, et. al. Infectious Complications Following ARI-0001 Cell (A3B1:CD8:4-1BB:CD3Z CART19) Treatment In Adult And Pediatric Patients With CD19+ Relapsed / Refractory Malignancies. Abstract PS1214; EHA Annual Meeting 2019.
  5. Ortiz-Maldonado V,  Alonso-Saladrigues A, Caballero-Baños M, et.al. Fractionated Dosing Of ARI-0001 Cells (A3B1:CD8:4-1BB:CD3Z CAR19) And Early Tocilizumab Administration May Reduce The Incidence Of Severe Cytokine Release Syndrome In Patients With CD19+ Malignancies. Abstract: S1636; EHA Annual Meeting 2019.
  6. Delgado J, Caballero-Baños M, Ortiz-Maldonado V, et al. Chimeric Antigen Receptor T Cells Targeting CD19 and Ibrutinib for Chronic Lymphocytic Leukemia. Hemasphere. 2019 Feb;3(2):e174.
  7. Castella M, Boronat A, Martín-Ibáñez R, et al. Development of a Novel Anti-CD19 Chimeric Antigen Receptor: A Paradigm for an Affordable CAR T Cell Production at Academic Institutions. Mol Ther Methods Clin Dev. 2019;12:134-144.
  8. Castella M, Caballero-Baños M, Ortiz-Maldonado V, et al. Point-Of-Care CAR Tcell Production (ARI-0001) Using a Closed Semi-automatic Bioreactor: Experience From an Academic Phase I Clinical Trial. Front Immunol. 2020 Mar;11:482.
  9. Ortiz-Maldonado  V, Rives S, Alonso-Saladrigues A, et.al. CART19-BE-01: A European Academic Trial On The Administration Of ARI-0001 Cells In Patients With Acute Lymphoblastic Leukemia And Other CD19+ Lymphoproliferative Disorders. Abstract S288; EHA Annual Meeting 2020.
  10. Ortiz Maldonado V, Rives S, Alonso-Saladrigues A, et.al. Factors Associated With Progression-free Survival (PFS) Of Adult And Pediatric Patients With Relapsed / Refractory B-cell Acute Lymphoblastic Leukemia Treated With ARI-0001 CART19 Therapy. Abstract EP734; EHA Annual Meeting 2021.
  11. Ortíz-Maldonado V, Rives S, Castellà M, et al. CART19-BE-01: A Multicenter Trial of ARI-0001 Cell Therapy in Patients with CD19+ Relapsed/Refractory Malignancies. Mol Ther. 2021 Feb;29(2):636-644.
  12. Ortíz-Maldonado V, Alonso-Saladrigues A, Español-Rego M, et al. Results of ARI-0001 CART19 cell therapy in patients with relapsed/refractory CD19-positive acute lymphoblastic leukemia with isolated extramedullary disease. Am J Hematol. 2022;97:731–739.
  13. Martinez-Cibrian N, Ortíz-Maldonado V, Español-Rego M, et al. Varnimcabtagene Autoleucel (var-cel) in Relapsed / Refractory CD19+ Non-Hodgkin Lymphoma. Abstract 1391; EHA Annual Meeting 2023