Pediatric Acute Leukemias

The term leukemia (“white blood” from Greek leukos [white] and haima [blood]) was coined by Rudolph Virchow in 1845 for a blood disease with a splenic enlargement (Virchow, Froiep Notizen 36:151–156, 1845). By 1913, four types of leukemia were recognized—chronic lymphocytic and myelogenous leukemias, acute lymphocytic leukemia, and erythroleukemia. Childhood leukemia was, however, not differentiated into lymphoid or myeloid till 1950, and was invariably fatal due to bleeding and/or infection (Ribatti, Pediatr Hematol Oncol 29:299–302, 2012). It is now broadly classified into acute lymphoblastic, myeloid, and mixed phenotypic leukemias—ALL, AML, and MPAL, respectively. Within the AMLs, acute promyelocytic leukemia (APML) is considered sufficiently distinct to merit separate attention. For the purpose of this chapter, ALL, AML, and APML are discussed as separate entities.