A 4-year-old girl presents with pallor, hepatosplenomegaly, and lymphadenopathy. CBC shows WBC 48,000/mm³ with 85% blasts, Hb 7.2 g/dL, platelets 38,000/mm³. Bone marrow biopsy confirms ALL. Which immunophenotype of ALL carries the BEST prognosis?
- A T-cell ALL
- B Pre-B cell ALL (CD19+, CD10+) — common ALL or c-ALL ✓
- C Mature B-cell ALL (Burkitt-type)
- D Infant ALL with MLL rearrangement
Correct answer: B. Pre-B cell ALL (CD19+, CD10+) — common ALL or c-ALL
Explanation
Common ALL (pre-B cell ALL, CD19+/CD10+/CALLA+ phenotype) is the most common type in children (2–5 years peak) and carries the best prognosis, with cure rates exceeding 90% with modern therapy. It is associated with favorable cytogenetics such as hyperdiploidy and ETV6-RUNX1 (TEL-AML1) translocation. T-cell ALL, mature B-cell (Burkitt) ALL, and infant ALL with MLL/KMT2A rearrangements all carry intermediate to poor prognosis.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.