Acute lymphocytic leukemia

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 hyperleukocytosis and leukostasis 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)
  • 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.