Abstract
This study included 40 patients with adult acute lymphoblastic leukemia. It is a retrospective study aimed at evaluation of the clinicopathologic profile, results of treatment, and the impact of various prognostic factors especially the BCR-ABL fusion gene on treatment, response and survival in the National Cancer Institute, Cairo University.

This study revealed the following:
- Age range (16-60 years) and the median (27 years).
- Male predominance (M/F ratio 2:1).
- BCR-ABL fusion gene was positive in 27.5% of our patients with predominance of P190 (72.7%).
- Regarding immunophenotyping, C-ALL + Pre. B represent 77.5% of our cases, pro-B represents 5% and T-ALL represents 17.5%.
- Regarding response to chemotherapy, 62.5% of the patients had a complete remission.

In conclusion, our results suggest that the BCR-ABL positive cases are easily induced into remission with aggressive chemotherapy and fail because of early relapse. So, this group might benefit from early intensification, such as allogenic bone marrow transplantation. It will be necessary to test this hypothesis with a larger population, ideally combined with close monitoring by molecular methods to elucidate the effects of treatment and the extent of residual disease, to confirm remission, and to predict relapse.