Diagnosis and treatment of acute lymphoblastic leukemia

Significant progress has been made in the treatment of ALL in children. In adults, however, results are still unsatisfactory. Our results are less encouraging. Aim: To evaluate the results of the GRAALL and GRAAPH protocols in the treatment of adult ALL and to propose a therapeutic algorithm adapted to the prognostic factors validated in our patients. Methods: Our study was retrospective. It included adults treated for ALL diagnosed at the Haematology Department of the Hédi Chaker University Hospital in Sfax. We studied the diagnostic characteristics, therapeutic results, evolution and prognostic factors of our population. Results and Discussion: We enrolled 49 patients, with a sex ratio of 0.88. The median age was 42 years. Hyperleukocytosis >30 G/l was observed in 28% of cases. LAL-B was found in 65% of cases, LAL-T in 33% and biphenotypic in 2%. Karyotyping was conclusive in 70% of cases, 54% of which had cytogenetic abnormalities. The overall CR rate was 93% for non-phi+ ALL and 90% for phi+ ALL, with failure rates of 5% and 10% respectively.