Acute lymphocytic leukemia: Difference between revisions
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==Background == | ==Background== | ||
*Characterized by proliferation of immature lymphoblast( | *Characterized by proliferation of immature lymphoblast( >20% in periphery) | ||
*Less than 20% of acute leukemias in adults, | *Less than 20% of acute leukemias in adults, | ||
*Most common form in children (see also [[Leukemia (Peds)]]) | *Most common form in children (see also [[Leukemia (Peds)]]) | ||
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==Clinical Features== | ==Clinical Features== | ||
*Lymphocytosis, neutropenia, anemia, thrombocytopenia | *[[leukocytosis|Lymphocytosis]], [[neutropenia]], [[anemia]], [[thrombocytopenia]] | ||
*Lymphadenopathy, hepatosplenomegaly | *[[Lymphadenopathy]], [[hepatomegaly|hepatosplenomegaly]] | ||
*CNS and testes involvement common | *CNS and testes involvement common | ||
*Symptomatic [[leukostasis and hyperleukocytosis]] are more common in AML than in ALL, CML, CLL<ref>Porcu P, Cripe LD, Ng EW, et al. Hyperleukocytic leukemias and leukostasis: a | |||
review of pathophysiology, clinical presentation and management. Leuk.Lymphoma. | |||
2000;39(1-2):1-18.</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
*CXR | *[[CXR]] | ||
*CBC with peripheral smear | *CBC with peripheral smear | ||
*Chem7, | *Chem7, Ca, Mg, Phos, Uric Acid, [[UA]], LDH (to check for [[tumor lysis syndrome]]) | ||
*LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC) | *[[LFTs]], Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for [[DIC]]) | ||
*ESR, CRP | |||
*Reticulocyte count in anemia | |||
*Get extra purple top for flow cytometry, especially before transfusion | *Get extra purple top for flow cytometry, especially before transfusion | ||
== | ==Management== | ||
*Aggressive IV hydration | *Aggressive [[IV hydration]] | ||
*If febrile, complete cultures and broad spectrum antibiotics | *If [[neutropenic fever|febrile]], complete cultures and broad spectrum [[antibiotics]] | ||
*Manage Complications | *Manage Complications | ||
**see [[DIC]] | **see [[DIC]] | ||
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**see [[Tumor Lysis Syndrome]] | **see [[Tumor Lysis Syndrome]] | ||
==See Also == | ==See Also== | ||
*[[Oncologic emergencies]] | *[[Oncologic emergencies]] | ||
*[[Acute leukemia]] | *[[Acute leukemia]] | ||
==References== | ==References== | ||
<references/> | |||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] |
Latest revision as of 23:21, 30 September 2019
Background
- Characterized by proliferation of immature lymphoblast( >20% in periphery)
- Less than 20% of acute leukemias in adults,
- Most common form in children (see also Leukemia (Peds))
- Highest incidence in 7th decade of life
Clinical Features
- Lymphocytosis, neutropenia, anemia, thrombocytopenia
- Lymphadenopathy, hepatosplenomegaly
- CNS and testes involvement common
- Symptomatic leukostasis and hyperleukocytosis are more common in AML than in ALL, CML, CLL[1]
Differential Diagnosis
Acute Leukemia/Lymphoma
Evaluation
- CXR
- CBC with peripheral smear
- Chem7, Ca, Mg, Phos, Uric Acid, UA, LDH (to check for tumor lysis syndrome)
- LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC)
- ESR, CRP
- Reticulocyte count in anemia
- Get extra purple top for flow cytometry, especially before transfusion
Management
- Aggressive IV hydration
- If febrile, complete cultures and broad spectrum antibiotics
- Manage Complications
- see DIC
- see Leukostasis
- see Tumor Lysis Syndrome
See Also
References
- ↑ Porcu P, Cripe LD, Ng EW, et al. Hyperleukocytic leukemias and leukostasis: a review of pathophysiology, clinical presentation and management. Leuk.Lymphoma. 2000;39(1-2):1-18.