Charles Mullighan, MBBS (Hons), MSc, MD, from St. Jude Children’s Research Hospital, Memphis, TN, outlines how genomics has revised the molecular classification of acute lymphoblastic leukemia (ALL) at the International Symposium on Acute Leukemias (ISAL) 2017 in Munich, Germany. He discusses the identification of multiple subtypes of leukemia, each of which has implications for how we understand leukemia so far, as well as how it can be diagnosed and treated. Dr Mullighan also describes studies of larger cohorts of ALL patients across an age range from children to older adults, which gives us a clearer understanding of the variations and prevalence of different subtypes. He points out that particularly some of the newly identified subtypes are more common in older adults than children, which may partially account for the poor outcomes with therapy.

14 hours long time lapse of a T cell acute lymphoblastic leukaemia (T-ALL) cells observed using confocal microscopy of live mouse calvarium bone marrow. The T-ALL cell expresses DsRed fluorescent protein (red) and also visible are bone marrow vasculature (cy5 dextran, blue) and GFP-expressing osteoblastic cells (green)

CTL019 is a clinical trial of T cell therapy for patients with B cell cancers such as acute lymphoblastic leukemia (ALL), B cell non-Hodgkin lymphoma (NHL), and the adult disease chronic lymphocytic leukemia (CLL). At this time, The Children's Hospital of Philadelphia is the only hospital enrolling pediatric patients on this trial. Scientists at The Children's Hospital of Philadelphia and the University of Pennsylvania are very hopeful that CTL019 could in the future be an effective therapy for patients with B cell cancers.

Jennifer Mack, MD, MPH, Medical Director of Inpatient Oncology at Dana-Farber/Boston Children's Cancer and Blood Disorders Center, discusses the cancer research currently underway at Dana Farber and Boston Children's regarding acute lymphoblastic leukemia (ALL).

Blood cancer, also known as hematologic cancer or hematological malignancy, refers to a group of cancers that affect the production and function of blood cells or the components of the blood, such as the bone marrow, lymphatic system, and blood cells themselves. There are three main types of blood cancer: leukemia, lymphoma, and multiple myeloma.

1. Leukemia: Leukemia is a type of cancer that affects the bone marrow and blood. It occurs when there is an abnormal production of white blood cells, which are responsible for fighting infections. The abnormal white blood cells multiply rapidly and overcrowd the normal blood cells, leading to a compromised immune system and other symptoms. There are four main types of leukemia: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML).

2. Lymphoma: Lymphoma is a cancer that affects the lymphatic system, which is a part of the immune system. It occurs when there is an abnormal growth of lymphocytes, a type of white blood cell, resulting in the formation of tumors in the lymph nodes or other lymphoid tissues. There are two main types of lymphoma: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).

3. Multiple Myeloma: Multiple myeloma is a cancer that affects plasma cells, which are a type of white blood cell that produces antibodies. In multiple myeloma, abnormal plasma cells accumulate in the bone marrow and interfere with the production of normal blood cells. This condition weakens the immune system and leads to complications such as bone pain, fractures, anemia, and kidney problems.

The exact causes of blood cancer are often unknown, but certain risk factors may increase the likelihood of developing these conditions, including genetic factors, exposure to certain chemicals and radiation, immune system disorders, and certain infections.

The diagnosis and treatment of blood cancer depend on the specific type, stage, and other factors. Treatments may include chemotherapy, radiation therapy, immunotherapy, targeted therapy, stem cell transplantation, and supportive care measures to manage symptoms and side effects.

If you suspect you or someone you know may have blood cancer or are concerned about any symptoms, it is important to consult a healthcare professional for a proper diagnosis and appropriate treatment options.
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Stephan Grupp, MD, PhD, of Children's Hospital of Philadelphia talked with us about acute lymphoblastic leukemia, its prevalence and prognosis in both children and adults.