Acute lymphocytic leukemia: Difference between revisions

(Text replacement - "==Diagnosis==" to "==Evaluation==")
 
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==Background ==
==Background==
*Characterized by proliferation of immature lymphoblast( >20% in periphery)  
*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, ca, mg, phos, Uric Acid, UA, LDH (to check for Tumor Lysis)  
*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


==Treatment ==
==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

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

See Also

References

  1. 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.