Acute lymphoblastic leukemia ALL

  • Facts:
    Predominant type of leukemia in kids 2-10 years old
  • History / PE:
    Thrombocytopenia (petecthiae, purpura, bleeding)
  • Diagnosis:
    Lymphoblasts ( > 25% ) on peripheral smear
    Periodic acid Schiff (PAS) positive material
    Terminal deoxynucleotidyltransferase (TdT) positive (expressed on pre B and pre T lymphoblasts)
  • Treatment:
    Bolod transfusions
  • Complications:
    Tumor lysis syndrome
  • Notes:
    85% of patients with ALL achieve complete remission with chemotherapy

    Poor prognosis
    Philidelphia chromosome t(9,22)
    L3 morphology (associated with Burkitt's lymphoma)
  • Differential Diagnosis:
    Acute myelogenous leukemia (Auer rods, myeloblasts, adults)
    Hodgkin's lymphoma

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August 7th 2010