Acute Lymphocytic Leukaemia

Question 1

Who is most affected ALL?

Answer 1

Children <6 y/o

Question 2

What is the pathology?

Answer 2

Overgrowth of lymphoid progenitor leading to uncontrolled differentiation into B cells that replace normal B cells

Question 3

What may be the cause if the ALL is T cells?

Answer 3

Thymoma

Question 4

Typical presentation?

Answer 4

” 4 y/o presents with tiredness, low grade fever, dyspnoea and bruising. O/e he has HSM. “

Question 5

What are 3 main symptoms?

Answer 5

HSM
Generalised lymphadenopathy
Fever
Thrombocytopaenia

Question 6

What is the character the lymphadenopathy?

Answer 6

Freely movable, soft

They are not cancerous they are reactive

Question 7

Investigation?

Answer 7

FBC

Blood smear

Bone marrow biopsy

Question 8

What may be seen on FBC in ALL?

Answer 8

Anaemia
Raised WCC
Thrombocytopenia

Question 9

What type of anaemia is seen in ALL?

Answer 9

Normocytic, normochromic anaemia

Question 10

What is seen on bone marrow biopsy?

Answer 10

> 20 % lymphoid blasts

Question 11

DDx?

Answer 11

AML

Question 12

How do you differentiate between AML and ALL?

Answer 12

Very hard
AML low WCC
Needs bone marrow bopsy

Question 13

Treatment ALL>

Answer 13

Chemotherapy

HSCT

Question 14

Treatment of tumour lysis syndrome?

Answer 14

Sodium bicarb
Rehydrate
Allopurinol