T-cell acute lymphoblastic leukemia
T-cell acute lymphoblastic leukemia (T-ALL) is a subtype of acute lymphoblastic leukemia (ALL), a cancer of the white blood cells. T-ALL affects T cells, a type of lymphocyte that plays a key role in the immune response.
Epidemiology
T-ALL accounts for approximately 15% of ALL cases in children and 25% in adults. It is more common in males than in females, and its incidence peaks in adolescence.
Pathophysiology
T-ALL is characterized by the malignant transformation and proliferation of immature T cells, or T lymphoblasts. This is often associated with genetic abnormalities, such as translocations and mutations, that disrupt normal T cell development.
Clinical presentation
Patients with T-ALL typically present with signs and symptoms of bone marrow failure, such as fatigue, pallor, and bleeding, as well as lymphadenopathy, hepatosplenomegaly, and sometimes mediastinal mass.
Diagnosis
The diagnosis of T-ALL is based on the morphological, immunophenotypic, and genetic analysis of peripheral blood and bone marrow samples. The presence of T lymphoblasts in these samples is indicative of T-ALL.
Treatment
The treatment of T-ALL involves intensive chemotherapy, often followed by stem cell transplantation in high-risk cases. Despite advances in treatment, the prognosis of T-ALL remains poor, particularly in adults.
Prognosis
The prognosis of T-ALL is generally worse than that of B-cell ALL, with lower rates of complete remission and higher rates of relapse. However, recent advances in treatment have improved the prognosis of T-ALL, particularly in children.
See also
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