Acute lymphocytic leukemia: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*[[leukocytosis|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 | *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 | ||
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.