Acute lymphocytic leukaemia

Question 1

who are most commonly affected?

Answer 1

children <6

Question 2

which age group have worse prognosis?

Answer 2

<1 year olds and >10 year olds

Question 3

which cells are affected?

Answer 3

B cell precursors

Question 4

symptoms

Answer 4

fatigue
fever 
unexplained bone/joint pain 
erythrocyte involvement 
WBC involvement
platelet involvement

Question 5

investigations

Answer 5

blood film
blood tests -FBC
bone marrow aspirate
immunophenotyping

Question 6

immunophenotyping

Answer 6

to determine subtype

Question 7

blood film findings

Answer 7

blasts

Question 8

erythrocyte involvement

Answer 8

anaemia

Question 9

WBC involvement

Answer 9

unexplained fever and recurrent infections

Question 10

platelet involvement

Answer 10

bruising
petechiae
bleeding

Question 11

diagnostic criteria

Answer 11

bone marrow dominant with lymphoblasts - >20%

Question 12

peripheral blood

Answer 12

blasts found

Question 13

partial remission

Answer 13

5-20% bone marrow cells are blasts with none in peripheral blood

Question 14

complete remission

Answer 14

<5% bone marrow cells are blasts

Question 15

treatment

Answer 15

chemotherapy in most cases unless mature B cells
staged chemo
supportive treatment
bone marrow transplant if very severe

Question 16

mature b cells

Answer 16

Burkitt’s lymphoma

Question 17

staged chemotherapy

Answer 17

1. aims to remove 99% of leukaemia cells - return to normal blood cell production + steroids
2. consolidation - intensifying previous stage to remove all malignant cells
3. maintenance - cytotoxic medication to reach stable remission

Question 18

prognosis

Answer 18

90% curative in children
if elderly low curative rate - 10%
worse if male