Several clinical characteristics-age, initial white blood cell (WBC) count, involvement of the central nervous system (CNS) disease at diagnosis, involvement of testis at diagnosis, immunophenotype, cytogenetics abnormalities-have been found to be associated with disease prognosis and outcomes. Patients with favorable prognosis are treated with less toxic regimen, while more aggressive regimens are offered to those with poor prognosis. The main components of treatment based on multidrug chemotherapy regimen to avoid drug resistance includes-remission induction, consolidation, interim maintenance, delayed intensification, maintenance chemotherapy, and CNS directed therapy (Cooper and Brown, 2015). With the incremental advances in therapy more than 80% survival (98% in certain subset) has been achieved in the developed countries (Gaynon et al., 1997).
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