Filip Chovanec, Alexandra Kolenová
Acute lymphoblastic leukemia is the most common type of childhood cancer. Clinical features, especially in early phase are nonspecific. In te primary care, suspicion of acute leukemia very often arises from combination of these nonspecific features and cytopaenias and leukocyte count changes. Development of the genetic and molecular methods has improved understanding of malignant cells biology and has revealed a intra-group heterogenity and specificity of each subtype of this malignancy. Based on biological background and clinical characteristics of leukemia, the patients are stratified into risk group with appropriate intensity of treatment. Risk-stratification has improved treatment outcome, reduced risk of relapse and reduced toxicity in patients with good prognosis. Further intensification of chemoterapy is not possible, because of drug toxicity. Contribution to continuous improvement of therapeutic outcome may present immunotherapy. On the present, imunotherapy is tested in the first line in ongoing clinical trial.