Acute Lymphoblastic Leukaemia (2)

Question 1

N.B. Most common leukaemia in children

What occurs here?
→ What does this lead to?

Answer 1

Uncontrolled proliferation of the lymphoid progenitor cell, which leads to lots of early lymphoid precursor cells replacing the normal haematopoietic cells of the bone marrow and infiltrating different organs
→ Pancytopenia (anaemia, leukopenia, thrombocytopenia)

Question 2

How does it present?

Answer 2

• Failure to thrive
• S+S of bone marrow failure
‣ Anaemia – Fatigue, Pallor
‣ Neutropenia – Recurrent infections
‣ Thrombocytopenia – Petechiae, Abnormal bruising, Unexplained bleeding
• S+S of organ infiltration
‣ Bone pain
‣ Lymphadenopathy
‣ Hepatosplenomegaly

Question 3

Which investigations are done?

How is it managed?

What’s the prognosis like?

Answer 3

➊ * FBC!
* Blood film, which will show blast cells
* Bone marrow and Lymph node biopsy

N.B. ALL is also associated with the Philadelphia chromosome (t(9;22) gene translocation), where it is a poor prognostic marker.

➋ * Chemotherapy
* Bone marrow transplant

➌ ~80% cure rate