Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children and a leading cause of cancer-related mortality among individuals younger than 20 years. It is a malignancy of the blood and bone marrow characterized by the uncontrolled production of immature white blood cells, known as lymphoblasts, which impair immune function and increase susceptibility to infections. Common symptoms include fatigue, recurrent infections, bruising, bleeding, and pallor. At diagnosis, leukemic cells may infiltrate the liver, spleen, lymph nodes, and mediastinal region. In some patients, ALL can spread to the central nervous system (CNS) or testes, requiring specialized treatment strategies. Diagnosis generally involves examination, blood tests, and bone marrow aspiration or biopsy.
Over recent decades, survival outcomes for children with ALL have improved remarkably, increasing from below 10% in the 1960s to 90% today. These advances have resulted from improved understanding of disease biology, risk classification, supportive care, and treatment protocols. Continued research is expected to further improve survival and quality of life.
In Iran, the incidence of ALL is approximately 2.25 cases per 100,000 children younger than 15 years, with higher rates among boys and a peak incidence at ages 2–5 years. Seasonal variation has also been reported, with higher incidence during spring and summer.
Improving physician awareness, diagnostic capacity, treatment access, and research into genetic factors is essential for reducing disparities and achieving optimal outcomes for children with ALL worldwide.