Definitions

Question 1

Steinhertz/Bleyer Algorithim

Answer 1

CSF WBC/CSF RBC = X. Serum WBC/Serum RBC = Y. If X is >2xY, there is CNS disease at diagnosis.

Question 2

ALL Relapse Definitions

Answer 2

Isolated Bone Marrow - M2 marrow (5-24% blasts by morphology, with >5% blasts by flow cytometry.

CNS Relapse - Positive cut-morphology with WBC >5 or clinical signs of CNS leukemia e.g. facial nerve palsy.

Testicular relapse - documented by testicular biopsy if isolated.

Extramedullary relapse - relapse occurring the in the CNS or testicle or other site.

Question 3

Relapse Timing - AALL1331

Answer 3

Low Risk:
> 18 months isolated extra medullary relapse

Intermediate Risk:
<18 months isolated extra medullary relapse
>36 months marrow

High Risk:
<36 months marrow (early marrow), all T-ALL/T-LyL

Question 4

Induction Failure

Answer 4

Defined as M2 or greater marrow.