Subtypes of childhood ALL

Childhood acute lymphoblastic leukemia (ALL) has different subtypes. Knowing the subtype of your child’s leukemia helps doctors to treat your child.

WHO ALL subtypes

The World Health Organization (WHO) classifies ALL based on how the leukemia cells (blasts) look under the microscope. It divides ALL into subtypes based on the type of cell involved (B or T cell) and how mature it is. Maturity is described as differentiation, which is the normal process by which immature (unspecialized) cells become mature (specialized) cells.

The WHO subtypes of ALL include:

B-cell ALL

  • precursor B-cell (early pre-B) ALL
  • pro B-cell ALL
  • mature B-cell ALL

T-cell ALL

The WHO also considers any genetic changes, such as translocation (rearrangement) of chromosomes, to classify ALL into subtypes.

B-cell ALL

  • B-lymphoblastic leukemia, not otherwise specified
  • B-lymphoblastic leukemia with recurrent genetic abnormalities
    • B-lymphoblastic leukemia with t(9;22)(q34.1;q11.2); BCR-ABL1
    • B-lymphoblastic leukemia with t(v;11q23.3); KMT2A rearranged
    • B-lymphoblastic leukemia with hyperdiploidy
    • B-lymphoblastic leukemia with hypodiploidy
    • B-lymphoblastic leukemia with t(5;14)(q31.1;q32.3); IL3-IGH
    • B-lymphoblastic leukemia with t(1;19)(q23;p13.3); TCF-PBX1
    • B-lymphoblastic leukemia, BCR-ABL1-like
    • B-lymphoblastic leukemia with iAMP21

T-cell ALL

  • early T-cell precursor lymphoblastic leukemia

Expert review and references

  • American Cancer Society. Childhood Leukemia Early Detection, Diagnosis and Types. 2016: https://www.cancer.org.
  • Bertolone, K. L. and W. Landier . Acute lymphoblastic leukemia. Baggott C, Fochtman D, Foley GV & Patterson Kelly, K (eds.). Nursing Care of Children and Adolsecents with Cancer and Blood Disorders. 4th ed. APHON; 2011: 25: pp. 935-966.
  • National Cancer Institute. Childhood Acute Lymphoblastic LeukemiaTreatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2012.
  • National Cancer Institute. Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®) Health Professional Version. 2018.

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