Acute Lymphocytic Leukaemia

Question 1

What is ALL?

Answer 1

Acute lymphocytic leukaemia

Proliferation of immature lymphoid cells (usually B cells)

Question 2

What are the risk factors for ALL?

Answer 2

Age (common in children)
Chemotherapy 
Radiotherapy 
Down's Syndrome 
Benzene exposure

Question 3

What is the pathophysiology of ALL?

Answer 3

Proliferation of lymphoblasts (commonly B cell lineage)

= accumulation of lympoblasts -> bone marrow failure + leakage of lymphoblasts into blood

Lymphoblasts invade other organs

Question 4

Where do lymphoblasts accumulate in ALL?

Answer 4

Liver
Spleen 
Bone marrow 
Lymph nodes
CNS
Parotid gland 
Testicle

Question 5

What is the most common translocation in children with ALL?

Answer 5

t(12;21)

Question 6

What investigations are done in suspected ALL?

Answer 6

FBC
Blood film
Bone marrow biopsy

Question 7

What does the FBC show in ALL?

Answer 7

Leucocytosis
Thrombocytopaenia
Anaemia

Question 8

What does the blood film show in ALL?

Answer 8

Immature lymphoblasts

Question 9

What does the bone marrow biopsy show in ALL?

Answer 9

> /= 20% lymphoblasts

Question 10

How is ALL managed?

Answer 10

Chemotherapy

Question 11

What are poor prognostis factors in ALL?

Answer 11

Age <1
Age >10 
WCC >30 at diagnosis 
t(9;22)
Extramedullary disease