Biologic features and treatment outcome of secondary acute lymphoblastic leukemia - A review of 101 cases

Background: Secondary acute lymphoblastic leukemia (sALL) is a rare disease and its biologic features are not well characterized. Patients and methods: We describe a cohort of seven patients and discuss 94 additional cases from the literature for whom biological parameters were described. Cases with incomplete data were excluded. Results: Hodgkin's disease (HD) was more common in the 18-59 age group while breast and prostate cancers were prevalent only in the ≥18-year-old patients. The time interval to develop sALL was similar among all age groups but was significantly longer for HD and neuroblastoma primary diagnoses and sALL with complex karyotype. T-cell immunophenotype was more common in the <18 age group. Complete remission was infrequent in the ≥60 age group. The overall survival was poor for all sALL regardless of age, primary diagnoses, cytogenetic subgroups, or immunophenotype. Allogeneic transplantation most probably represents the only chance of cure. Conclusion: Better identification of prognostic factors to prevent the occurrence of sALL is indicated.