Acute lymphocytic leukemia

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  • 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


  • 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


See Also


  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.