<prompt> All of the following are good prognostic factors for childhood. ALL except:HyperdiploidyFemale sexPre B cell ALLt 12 : 21 translocation  <response>: Answer is C Pre B cell ALL Hyperdiploidy, Female sex and translocation t 12, 21 are associated with good prognosis. Pre B cell ALL may be associated with a poor prognosis and is the single answer of exclusion. Hyperdiploidy Female sex and translocation t 12, 21 are associated with good prognosis. Prognostic factor for ALL: Determinants Favourable Unrourable White blood cell count Low WBC count High WBC count Age 3-7 yrs 1, 10 yr Gender Female Male Ethnicity White Black Node, Liver, spleen enlargement Absent Massive Testicular enlargement Absent Present Central nervous system leukemia Absent Ove blasts pleocytosis FAB morphological features L 1 L2 Ploidy Hyperdiploidy Hypodiploidy 45 DNA index 0.16 0.16 Cytogenenetic markers Trisomies 4, 10 andor 17 t12;21 tel aml 1 t9; 22 t4; 11 t1; 19 Time to remission 14 d 28 d Minimal residual disease 104 10-3 Immunophenotype Early Pre-B cell T cell Pre B cell ALL is often associated with an unourable prognosis although it may be associated with a ourable outcome Pre B cell ALL has been associated with a poorer outcome compared to Early Pre B cell ALL. - Wintrobes Immunophenotype and Prognosis Early Pre B cell ALL Pre B cell ALL Mature B cell ALL T cell ALL Early Pre B cell All Pre B cell ALL account for Mature B cell ALL in T cell ALL accounts for comprises about 23 20 of childhood ALL uncommon in children and 15 of ALL in children cases of childhood ALL and have been associated accounts for 1-2 of T cell ALL was and is associated with a with a poorer outcome childhood ALL. previously associated ourable prognosis. compared to Early Pre B It is characterized by L3 with a poor prognosis but Most Early Pre B cell cell ALL. FAB morphology and has recent use of more ALL are CALLA positive. CALLA expression does not appear to have independent prognosis significance. a poor prognosis. intensive therapeutic regimen has resulted in survival approaching that of Non T cell ALL. 