ALL and CLL

Question 1

Who is there majority of ALL seen in?

Answer 1

75% <6yo

Accounts for ~80% childhood leukaemia

Question 2

What is the presentation of ALL?

Answer 2

2-3 weeks bone marrow failure- bleeding, bruising, infection, anaemia
Hepatosplenomegaly
Infection
Sweats

Question 3

What investigations are done for ALL?

Answer 3

FBC- thrombocytopenia and anaemia, high WCC with neutropenia
Blood film
Bone marrow aspiratte= hyper cellular, infiltration by lymphoblasts

Question 4

What is the management of ALL?

Answer 4

Intensive chemo
High risk= stem cell transplant
New mx= bispecific T cell engagers
CAR T cells

Question 5

What is the prognosis of ALL?

Answer 5

5 year survival
Kids= 90%
Aduts= 35%

Question 6

What is the presentation of CLL?

Answer 6

Asymptomatic
Common= lymphadenopathy, splenomegaly, fever, sweats, fatigue
Less common= hepatomegaly, weight loss, infection

Question 7

What investigations are done for CLL?

Answer 7

FBC- high WCC with absolute lymphocytosis

Blood film- m=smudge/smear cells

Question 8

What is the management of CLL?

Answer 8

Treat if symptomatic, progressive or severe
Chemo
Targeted therapy- Monoclonal antibodies, novel agents