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Access Type

WSU Access

Date of Award

January 2020

Degree Type


Degree Name



Cancer Biology

First Advisor

Ramzi Mohammad


Acute lymphoblastic leukemia (ALL) is the most prevalent type of leukemia among children. It is characterized by chromosomal and genetic variations and abnormalities occurring in the leukemic cells. Prognosis predictors of ALL depend on risk-based stratification and the reaction to the initial therapy. Current treatment regimens of ALL contribute to the survival of approximately 80% of pediatric ALL patients with 90% 5-year event-free survival. Based on the patient’s features impacting prognosis and risk of therapy failure, cases can be designated to receive the adequate type of treatment regimens. The higher the risk, the more aggressive, intensive, and toxic is the treatment regimen. Chemotherapy is the base of ALL treatment and it is composed of 4 major phases, remission induction, consolidation, maintenance, and therapy directed mainly to the central nervous system (CNS). There is a high risk for a multitude of complications and medical problems associated with toxic chemotherapy regimens used with pediatric ALL patients. Some of these complications are pulmonary embolism, concurrent diabetic ketoacidosis and pancreatitis, cancer-related fatigue, steroid-induced glaucoma, osteonecrosis, tumor lysis syndrome, varicella‐zoster virus infection, invasive fungal infections, and oral mucositis. However, early detection of these complications can contribute to a lower risk of morbidity and mortality.

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