Acute lymphoblastic leukemia ALL

• Facts:
  Predominant type of leukemia in kids 2-10 years old
• History / PE:
  Lymphadenopathy
  Splenomegaly
  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:
  Chemotherapy
  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