Oncology

Acute Lymphoblastic Leukemia

급성림프구성백혈병

Most common pediatric leukemia

How common
A measurable share of cancer diagnoses
Typical age
Variable age

What is it?

Acute Lymphoblastic Leukemia arises from accumulated driver mutations and altered tumor microenvironment.

Commonly affected: bone marrow and distant metastatic sites

How it develops

  1. Initiating eventExposure to risk factors (다운증후군·방사선)
  2. Aberrant growthClonal expansion in bone marrow
  3. Local invasionBasement membrane breach, neoangiogenesis
  4. Lymphatic & distant metastasisSpread to lymph nodes and distant organs

Symptoms

  • Local symptomsSite-specific signs of Acute Lymphoblastic Leukemia
  • Weight loss/anorexiaCachexia is common
  • Fatigue/astheniaCommon in advanced disease
  • LymphadenopathyRegional or distant nodes

How it is examined

  • Staging assessmentApply TNM or disease-specific staging
  • PS/comorbiditiesECOG PS, nutrition, comorbidities

Imaging

CXR/AXR to screen for obvious metastases.

  • Metastatic nodules
  • Lymphadenopathy

CT/MRI/PET-CT for precise staging + tissue biopsy.

  • Primary tumor
  • Nodal involvement
  • Distant metastasis

Non-surgical care

  • Multidisciplinary tumor boardMed-onc, surgery, RT, pathology
  • ChemotherapyDisease-specific standard regimens
  • Targeted/immunotherapyTargeted/IO based on molecular markers
  • Palliative/supportive careSymptom control, nutrition, psychosocial, hospice

Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.

When surgery is considered

Resectable localized tumor or palliation of complications

Procedures that may be discussed

  • Curative resection + lymphadenectomy
  • Neoadjuvant/adjuvant chemoRT combination
  • Palliative surgery (obstruction/bleeding)

Outlook

Varies by stage, molecular subtype, treatment response.

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