Acute lymphoblastic leukemia - diagnosis and therapy Abstract. Acute lymphoblastic leukemia (ALL) is a rare malignant hematological disease. The incidence of the disease peaks in the childhood and thus is rare in adults, making assessment and care at qualified centers highly desirable. Clinically, ALL presents with the proliferation and accumulation of malignant, immature lymphatic blasts in the bone marrow, peripheral blood, and lymphatic and non-lymphatic tissue. Untreated, ALL results in death within few months. ALL is a heterogeneously disease. Prognosis is determined by immunophenotype, cytogenetics and molecular markers which influences therapeutic strategies. The aim of therapy in younger patients is curative. Patients should be treated in international study group protocols. Overall survival has improved over the last decade; also with the introduction of new targeted therapies. In addition, there have been recent developments in minimal / measurable residual disease (MRD) determination, which has a strong impact on the decision for an allogeneic hematopoietic stem cell transplantation.