Acute Lymphoblastic Leukemia is the most common childhood malignancy
with over 80% cure rates in most parts of the world. Nevertheless,
genetic abnormalities that are the major prognostic and determinants of
treatment decision-making are not uniformly distributed in different
geographic regions of the word, specifically fusion oncogenes. This is
due to ethnic differences, racial and environmental variations,
population mixing and delayed exposure to infection and drastic
difference of socio-economic status. Because of huge clinical
implications of genetics in pediatric ALL, it is one of the major
contributing factors of disparities in ALL cure rates between developed
world and developing countries. Therefore, cost-effective genetic
testing should be part of routine clinical decision making in
underdeveloped countries. Moreover, state-of-the-art genomic
technologies should be employed to further explore variations in genetic
epidemiology of ALL and its impact on differential diagnosis, prognostic
stratification and therapeutic decision-making.