**Abstract**

When diagnosed with ALL the age group between 18 and 45 years old (AYA, adolescents and young adults) do not have the good prognosis factors generally observed in children with this diagnosis. For a long time, it was undetermined whether they should be treated with continuous and sustained chemotherapy as children or whether receive sustained chemotherapy, but with longer rest periods like old adults. The medical care of adolescents and young adults with neoplastic diseases, grouped between 15 and 45 years of age, became an emerging research field of treatment in hematological diseases. Outcomes have asses complete response disease-free survival, and overall survival as markers of response, with very poor results reported. Relevant challenges have been identified in the AYA group with ALL that have drawn attention to the need to increase research in this area, particularly in the care of the population under 45 years of age with hematological malignancies.

**Keywords:** acute lymphoblastic leukemia, remission, relapse, treatment, adult young and adolescents, bone marrow transplant

## **1. Introduction**

Acute lymphoblastic leukemia (ALL) is an oncohematological disease caused by genetic changes that alter the differentiation and proliferation of lymphocytes, distinguished by the infiltration of bone marrow, blood, and other tissues by neoplastic cells of hematopoietic origin [1]. The pathophysiology of these disease include causes for which, certain genes result affected in their function. Patients could present the following symptomatology: fever, lymphadenopathy, coagulation disorders, anemia, hepato-splenomegaly, weight loss, among others.

Another definition of ALL could be a disease caused by an acquired or congenital injury to the hematopoietic cell DNA (the genetic material) developing in the bone marrow, once these cells transform into a leukemic clone multiplies uncontrollably and rapidly in billions of malignant cells called lymphoblasts that prevents the

normal cellular production of leukocytes, platelets and red blood cells. As a result, when a patient is diagnosed with acute lymphoblastic leukemia, the number of healthy blood cells (red blood cells, white blood cells, and platelets) could be less than normal, although it is not uncommon to see an exaggerated elevation of white blood cells but all of them lymphoblasts.

It is more frequent in childhood than in adulthood, being the most common type of leukemia in children, with a peak of incidence between the 2 and 4 years old. When it appears in adulthood, it implies a worse prognosis.
