acute lymphoblastic leukaemia

Question 1

age

Answer 1

Commonest childhood cancer - 75% age ≤ 6

Question 2

lymph or bone marrow

Answer 2

ALL in lymph nodes but NOT in the bone marrow

Question 3

risk factors

Answer 3

No obvious risk factor for most
Down syndrome may pre-dispose

Question 4

presentation

Answer 4

ABNORMAL FULL BLOOD COUNT

“Blasts” – immature cells on blood film - very very alarming

Anaemia + ↓thrombocytoneamia most commonly

WCC may be high due to blasts - not very reliable does vary

Fatigue, bone pain

Bleeding/bruising/petechial rash

Lymphadenopathy/ organomegaly/ mass lesions in some cases

Mediastinal mass common in T-ALL or “lymphoblastic lymphomas”

Question 5

important diagnostic test

Answer 5

BONE MARROW BIOPSY
>20% blasts and characteristic p[attern of cell markers

Question 5

Treatment

Answer 5

Rapidly progressive over days-weeks
Start treatment ASAP
Intensive chemotherapy

Complex regimes:
Full treatment course up to 2-3 years
High risk - donor stem cell transplant

Question 6

prognosis

Answer 6

Children >90% cured
Adults <50% cured