Presentation
Common therapeutic dilemmas, presented as several case scenarios, are also discussed. [haematologica.org]
Elevated serum hepatic transaminases or creatinine, and hypoglycemia may also be present. Patients with Ph ALL and patients with t( v ;11q23) involving MLL rearrangements often present with hyperleukocytosis. [msdmanuals.com]
Rarely, some patients may also present with neurological symptoms (e.g., headaches, nuchal rigidity, vomiting, or nerve palsies). [cancertherapyadvisor.com]
Either of these is present in 5% of pediatric to 30% of adult T-ALL [ 1 ]. [intechopen.com]
One blast soon generates billions of other blasts, with a total of about a trillion (one million times one million) leukemia cells typically present in the body at the time of diagnosis. Symptoms of ALL Leukemia cells "crowd out" normal blood cells. [childrensoncologygroup.org]
Hematological
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Easy Bruising
Symptoms of ALL include: Weakness or feeling tired Fever Easy bruising or bleeding Bleeding under the skin Shortness of breath Weight loss or loss of appetite Pain in the bones or stomach Pain or a feeling of fullness below the ribs Painless lumps in [medlineplus.gov]
A decline in platelets that normally help the blood clot may lead to easy bruising or bleeding. A decline in white blood cells puts patients at increased risk for infections that can be life threatening. [cancer.columbia.edu]
ALL spreads to the blood fairly quickly, and then may spread to other areas of the body such as the lymph nodes, liver, spleen, central nervous system, and testicles (in males). [2] Signs and symptoms of ALL may include fever, easy bruising or bleeding [rarediseases.info.nih.gov]
bruising or bleeding Petechiae (flat, pinpoint spots under the skin caused by bleeding) Shortness of breath Weight loss Loss of appetite Bone or joint pain Stomach pain Pain or a feeling of fullness below the ribs Painless lumps in the neck, underarms [uvahealth.com]
bruising Swollen lymph nodes around the neck, underarm, stomach or groin Shortness of breath Weight loss Acute lymphocytic leukemia treatment options Treatment for ALL may include chemotherapy, chemotherapy with stem cell transplant, radiation therapy [cancercenter.com]
Entire Body System
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Fever
When seen together, these signs “should prompt a bone marrow examination in the presence of fever or elevated inflammatory markers,” the researchers said. [juvenilearthritisnews.com]
(Lucas, diagnosed at age 2.5) Pale skin, slight bruising, lethargic, low grade unexplained fever. (Girl, diagnosed at age 3) Fevers for a month abs complained of muscle ache in the leg. [lifey.org]
Recurrent fevers/infections. The child with leukemia often shows non-specific symptoms of infection such as fever and fatigue. [chop.edu]
Fever : Many children with ALL have fevers that are not related to a specific infection, though sometimes fever at the time of diagnosis can be a sign of infection. [danafarberbostonchildrens.org]
Symptoms of ALL include: Weakness or feeling tired Fever Easy bruising or bleeding Bleeding under the skin Shortness of breath Weight loss or loss of appetite Pain in the bones or stomach Pain or a feeling of fullness below the ribs Painless lumps in [medlineplus.gov]
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Anemia
Fanconi anemia : This type of inherited anemia is a very rare, recessive genetic disorder that leads to bone marrow failure. [physio-pedia.com]
As the number of oxygen-carrying red blood cells decline, patients may develop anemia, appearing pale, tired or short of breath. A decline in platelets that normally help the blood clot may lead to easy bruising or bleeding. [cancer.columbia.edu]
The most common signs and symptoms of acute lymphoblastic leukemia in children are: Anemia. Anemia occurs when normal red blood cells can't be produced because the bone marrow is overcrowded by leukemia cells. [chop.edu]
Anemia is a condition when there is a low number of red cells in the blood which can cause fatigue and shortness of breath. [lls.org]
Side effects of the many chemotherapy medicines include, but are not limited to the following: nausea and vomiting, diarrhea, mouth sores, anemia, increased risk of infections, and bleeding. C. [cancertherapyadvisor.com]
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Fatigue
Even without those signs, bone marrow analysis should still be performed in children with symptoms that include fever, non-articular bone pain, weight loss, fatigue, and low white blood cell and platelet levels, they said. [juvenilearthritisnews.com]
It is the decrease in normal cells that produces many of the symptoms of ALL Fatigue and being pale results from a decreased number of red blood cells, known as anemia Fever due to the disease itself or from infection because there are a decreased number [childrensoncologygroup.org]
Low levels of other blood cells can cause a variety of symptoms such as bleeding problems, fatigue and shortness of breath. The cause of ALL is unknown. Risk Factors ALL is more common in white males and adults over 70 years of age. [uvahealth.com]
The decrease in normal cells causes the symptoms of leukemia, which may include: Fatigue and being pale results from a decreased number of red blood cells, known as anemia Fever due to the disease itself or from infection because there are a decreased [curesearch.org]
Fever, fatigue, and excessive sweating are possible symptoms of ALL. Leukemia happens when the body produces too many immature white blood cells, or blast cells. In the case of ALL, it produces too many lymphoblasts or lymphocytes. [medicalnewstoday.com]
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Pallor
ulcerations of the mouth and throat high numbers of immature or abnormal leukocytes unable to fight and destroy microorganisms increased metabolic rate accompanied by weakness, pallor, and weight loss increased leukocyte production requiring large amounts [physio-pedia.com]
Symptoms include fatigue, pallor, infection, bone pain, CNS symptoms (eg, headache), easy bruising, and bleeding. Examination of peripheral blood smear and bone marrow is usually diagnostic. [msdmanuals.com]
pallor, lethargy). Other findings include abdominal masses due to hepatosplenomegaly, cachexia and lymphadenopathy. Rarely, some patients may also present with neurological symptoms (e.g., headaches, nuchal rigidity, vomiting, or nerve palsies). [cancertherapyadvisor.com]
Children and adolescents suffering from ALL initially experience general symptoms such as fatigue, pain, and pallor. This is due to the lack of red blood cells (anaemia), the function of which it is to carry oxygen to cells throughout the body. [kinderkrebsinfo.de]
General features of acute leukemia Sudden onset of symptoms and rapid progression (days to weeks) Anemia : fatigue, pallor, weakness Thrombocytopenia : epistaxis, bleeding gums, petechiae, purpura Immature leukocytes : frequent infections, fever Hepatomegaly [amboss.com]
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Malaise
Systemic Involvement Pathologic basis for the clinical manifestations of leukemia Presentation Cause anemia, pallor, fatigue, malaise, hypoxia, bleeding rapidly proliferating development of leukocytes inhibiting erythrocytes and thrombocytes severe infections [physio-pedia.com]
The most common presenting symptoms are due to disrupted hematopoiesis with ensuing Anemia Thrombocytopenia Granulocytopenia Anemia can manifest with fatigue, weakness, pallor, malaise, dyspnea on exertion, tachycardia, and exertional chest pain. [msdmanuals.com]
Anaemia – due to lack of red blood cells Weakness, tiredness, shortness of breath, light-headedness, palpitations Infections – due to lack of normal white blood cells Infections are more frequent, more severe and last longer Fever, malaise (general feeling [leukaemiacare.org.uk]
Initial presentation is usually generalised fatigue and malaise but usually quickly progresses to bone marrow failure [ 1 ]. Symptoms Fatigue, dizziness and palpitations. Severe and unusual bone and joint pain. [patient.info]
Immune System
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Splenomegaly
Surgical consults could also be included in the plan of care for patients with severe splenomegaly and/or bulky/painful lymphadenopathy. Once treatment is initiated, the specialist(s) can decide on further follow-up. [cancertherapyadvisor.com]
Minor prognostic factors, or those that have had some significance with certain treatment regimens, are the percentage of circulating blast cells; the degree of bone marrow involvement; the presence of hepatomegaly, splenomegaly, or lymphadenopathy; lactate [cancernetwork.com]
Left upper quadrant fullness and early satiety due to splenomegaly (10-20%). Dyspnoea (due to anaemia or large mediastinal mass in those with T-cell tumours). [patient.info]
Collections of monocytes in the spleen lead to enlargement (splenomegaly) which can cause pain in the left upper abdomen and fullness with eating. [verywellhealth.com]
[…] of acute leukemia Sudden onset of symptoms and rapid progression (days to weeks) Anemia : fatigue, pallor, weakness Thrombocytopenia : epistaxis, bleeding gums, petechiae, purpura Immature leukocytes : frequent infections, fever Hepatomegaly and/or splenomegaly [amboss.com]
Respiratoric
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Dyspnea
Dyspnea (difficulty breathing) : In some cases of ALL, leukemia cells tend to clump together and form a mass in the middle of the chest. This chest mass can cause pain and difficulty breathing in your child. [danafarberbostonchildrens.org]
The most common presenting symptoms are due to disrupted hematopoiesis with ensuing Anemia Thrombocytopenia Granulocytopenia Anemia can manifest with fatigue, weakness, pallor, malaise, dyspnea on exertion, tachycardia, and exertional chest pain. [msdmanuals.com]
[…] leukemic cells usually suppresses one or more cell lines, leading to recurrent infections (due to granulocytopenia), easy/excessive bruising, petechiae, mucocutaneous bleeding and other bleeding (from thrombocytopenia), and anemia (causing fatigue, dyspnea [cancertherapyadvisor.com]
Symptoms of hematological deficiency are: Anemia: pallor of skin and mucous membranes, tachycardia, dyspnea, vertigo, decreased physical fitness Granulocytopenia in patients with leukocytopenia, leukocytosis, or regular total leukocyte counts in the blood [onkopedia-guidelines.info]
Signs and symptoms Signs and symptoms of ALL include the following: Fever Signs and symptoms of anemia, such as pallor, fatigue, dizziness, palpitations, cardiac flow murmur, and dyspnea with even mild exertion Bleeding Blood clots Palpable lymphadenopathy [emedicine.medscape.com]
Jaw & Teeth
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Bleeding Gums
gums Frequent infections Nosebleeds Easy bruising Swollen lymph nodes around the neck, underarm, stomach or groin Shortness of breath Weight loss Acute lymphocytic leukemia treatment options Treatment for ALL may include chemotherapy, chemotherapy with [cancercenter.com]
This shortage can cause the following symptoms: Fatigue Feeling weak, or low energy Dizziness or lightheadedness Shortness of breath Fever Inability to get rid of an infection Bruises easily Bleeding, as with bleeding gums and severe nosebleeds Other [uihc.org]
gums, or other unusual bleeding, such as from minor cuts Depending on where the leukemia cells are, you might also have: A full or swollen belly from cancer cells in your liver or spleen Enlarged lymph nodes such as in your neck or groin, under your [webmd.com]
Symptoms can be non-specific and may include feeling weak and tired, paler skin, bruises, frequent and severe bleeding gums, nose bleeds; weight loss, shortness of breath, and loss of appetite. [alliedmarketresearch.com]
Some of the most common symptoms include: Feeling weak, extremely tired, dizzy or light-headed, or appearing abnormally pale Bruising or bleeding easily, especially frequent or severe nosebleeds and bleeding gums Fevers, recurring or long-lasting infections [cancersupportcommunity.org]
Liver, Gall & Pancreas
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Hepatomegaly
Minor prognostic factors, or those that have had some significance with certain treatment regimens, are the percentage of circulating blast cells; the degree of bone marrow involvement; the presence of hepatomegaly, splenomegaly, or lymphadenopathy; lactate [cancernetwork.com]
Collections of monocytes can cause enlargement of the liver (hepatomegaly) resulting in pain in the right upper abdomen as well. [verywellhealth.com]
General features of acute leukemia Sudden onset of symptoms and rapid progression (days to weeks) Anemia : fatigue, pallor, weakness Thrombocytopenia : epistaxis, bleeding gums, petechiae, purpura Immature leukocytes : frequent infections, fever Hepatomegaly [amboss.com]
( 100,000/mm3) with or without lymphadenopathy, hepatomegaly, splenomegaly, or anemia Binet classification[31] Clinical stage A: characterized by no anemia or thrombocytopenia and fewer than three areas of lymphoid involvement (Rai stages 0, I, and II [en.wikipedia.org]
Abdominal distention due to hepatomegaly and splenomegaly. Lymphadenopathy. Testicular enlargement. Gum hypertrophy. Leukaemia cutis [ 9 ]. Cranial nerve palsy (especially III, IV, VI and VIII) in mature B-cell ALL. [patient.info]
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Hepatosplenomegaly
However, in cases without hepatosplenomegaly or lymph node swelling, and when complaints of joint and bone pain are restricted to one part of the body, differentiating between ALL and non-systemic forms of JIA may be more challenging. [juvenilearthritisnews.com]
The most frequent signs are lymphadenopathies, hepatosplenomegaly, fever, signs of haemorrhage, and bone pain. [orpha.net]
CT of the chest and abdomen should be done to detect mediastinal masses and lymphadenopathy and may also detect hepatosplenomegaly. [msdmanuals.com]
Other findings include abdominal masses due to hepatosplenomegaly, cachexia and lymphadenopathy. Rarely, some patients may also present with neurological symptoms (e.g., headaches, nuchal rigidity, vomiting, or nerve palsies). [cancertherapyadvisor.com]
Leukemic cells also infiltrate extramedullary organs, resulting in hepatosplenomegaly and, less commonly, involvement of the skin, CNS, and/or scrotum. [amboss.com]
Cardiovascular
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Tachycardia
The most common presenting symptoms are due to disrupted hematopoiesis with ensuing Anemia Thrombocytopenia Granulocytopenia Anemia can manifest with fatigue, weakness, pallor, malaise, dyspnea on exertion, tachycardia, and exertional chest pain. [msdmanuals.com]
Symptoms of hematological deficiency are: Anemia: pallor of skin and mucous membranes, tachycardia, dyspnea, vertigo, decreased physical fitness Granulocytopenia in patients with leukocytopenia, leukocytosis, or regular total leukocyte counts in the blood [onkopedia-guidelines.info]
Tachycardia and a flow murmur. Nonspecific signs of infection. Petechiae (due to thrombocytopenia), may progress into purpura or ecchymoses. Abdominal distention due to hepatomegaly and splenomegaly. Lymphadenopathy. Testicular enlargement. [patient.info]
Skin
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Petechiae
[…] including X-rays and CT scans Previous chemotherapy or other treatment that weakens the immune system Symptoms of ALL You should see a doctor if you or your child is experiencing: Weakness Tiredness Fever Pale skin Night sweats Easy bruising or bleeding Petechiae [uvahealth.com]
Signs & Symptoms These are signs of ALL: Having many infections Fever or night sweats Shortness of breath Easy bruising or bleeding Flat spots under the skin, also called petechiae Painless lumps in the neck, underarm, stomach or groin Pain or feeling [healthcare.utah.edu]
Symptoms of ALL include: Frequent infections Fever Easy bruising Bleeding that is hard to stop Flat, dark-red skin spots (petechiae) due to bleeding under the skin Pain in the bones or joints Lumps in the neck, underarm, stomach or groin Pain or fullness [stjude.org]
These include: being very tired, weak, or pale swollen lymph nodes infections (like bronchitis or tonsillitis) that keep coming back a fever night sweats easy bruising or petechiae (tiny red spots on the skin caused by easy bleeding) bone and joint pain [kidshealth.org]
Bruising or petechiae : When the marrow is too crowded to allow platelets to be produced, your child may bruise more easily. You might notice petechiae, or tiny red dots, on the skin if your child has a low number of platelets. [danafarberbostonchildrens.org]
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Purpura
Thrombocytopenia can cause mucosal bleeding, easy bruising, petechiae/purpura, epistaxis, bleeding gums, and heavy menstrual bleeding. Hematuria and GI bleeding are uncommon. [msdmanuals.com]
[…] bleeding, such as bleeding gums or nosebleeds high temperature night sweats bone and joint pain easily bruised skin swollen lymph nodes (glands) tummy (abdominal pain) – caused by a swollen liver or spleen unintentional weight loss a purple skin rash (purpura [nhs.uk]
[…] blood cells Weakness, tiredness, shortness of breath, light-headedness, palpitations Infections – due to lack of normal white blood cells Infections are more frequent, more severe and last longer Fever, malaise (general feeling of illness) and sweats Purpura [leukaemiacare.org.uk]
General features of acute leukemia Sudden onset of symptoms and rapid progression (days to weeks) Anemia : fatigue, pallor, weakness Thrombocytopenia : epistaxis, bleeding gums, petechiae, purpura Immature leukocytes : frequent infections, fever Hepatomegaly [amboss.com]
Petechiae (due to thrombocytopenia), may progress into purpura or ecchymoses. Abdominal distention due to hepatomegaly and splenomegaly. Lymphadenopathy. Testicular enlargement. Gum hypertrophy. Leukaemia cutis [ 9 ]. [patient.info]
Musculoskeletal
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Bone Pain
In 15–30% of children, ALL is diagnosed based on a history of isolated, but persistent, episodes of joint and bone pain that are not associated with blood abnormalities. [juvenilearthritisnews.com]
pain, sometimes associated with swelling of the joints The signs and symptoms of ALL can be the same as more common children’s illnesses and many children are treated for those other illnesses before leukemia is diagnosed. [childrensoncologygroup.org]
pain, sometimes associated with swelling of the joints Weight loss or loss of appetite Enlarged lymph nodes The signs and symptoms of ALL can be the same as more common children’s illnesses and some children are treated for those other illnesses before [curesearch.org]
The most frequent signs are lymphadenopathies, hepatosplenomegaly, fever, signs of haemorrhage, and bone pain. [orpha.net]
A high number of leukemia cells can cause bone pain and swelling of the joints. How is research helping to fight this type of cancer? In the 1950s, an ALL diagnosis was almost always fatal. [stbaldricks.org]
Face, Head & Neck
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Epistaxis
Thrombocytopenia can cause mucosal bleeding, easy bruising, petechiae/purpura, epistaxis, bleeding gums, and heavy menstrual bleeding. Hematuria and GI bleeding are uncommon. [msdmanuals.com]
ALL is associated with a wide variety of physical examination findings, which include signs of easy bleeding (from thrombocytopenia) such as recurrent epistaxis, bruises and petechiae, recurrent infections (e.g., pneumonia), and signs of anemia (e.g., [cancertherapyadvisor.com]
General features of acute leukemia Sudden onset of symptoms and rapid progression (days to weeks) Anemia : fatigue, pallor, weakness Thrombocytopenia : epistaxis, bleeding gums, petechiae, purpura Immature leukocytes : frequent infections, fever Hepatomegaly [amboss.com]
Neurologic
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Headache
Acute lymphocytic leukemia symptoms ALL symptoms are often similar to those of the flu and can include the following: Fever Weakness Fatigue Headaches Loss of appetite Pale skin Vomiting Body aches Other potential signs and symptoms of ALL may include [cancercenter.com]
The most common neurologic symptoms after blinatumomab use are headache and tremor ( 3 ). [msdmanuals.com]
Leukemia cells: An increased number of these cells can cause pain in the bones or joints, lack of appetite, headache or vomiting. [physio-pedia.com]
[…] of appetite Night sweats Some of the less commonly seen symptoms include: Lumps under the skin (swollen lymph nodes) Bone and joint pain Swelling in the abdomen Respiratory problems, such as trouble breathing or coughing Neurologic problems, such as headaches [cancersupportcommunity.org]
The cells sometimes – though not often – spread to other organs, and can cause more symptoms there: headaches, seizures and vomiting if the leukemia has spread to the brain or spinal cord, or difficulty breathing if it has spread to the chest cavity, [uihc.org]
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Confusion
Differential Diagnosis Other diseases may be confused with ALL, the most common of which are listed in Table 2. [cancernetwork.com]
Such instances include: Intracranial hemorrhage: Bleeding into the brain can result in the rapid onset of confusion or unconsciousness. Pulmonary hemorrhage: Bleeding in the lungs may result in severe shortness of breath and coughing up blood. [verywellhealth.com]
[…] the skull (intracranial haemorrhage) inside the lungs (pulmonary haemorrhage) inside the stomach (gastrointestinal haemorrhage) The symptoms of an intracranial haemorrhage include: severe headache stiff neck vomiting change in mental state, such as confusion [nhsinform.scot]
However, these are now recognized as a separate disease group and are currently classified as T-cell prolymphocytic leukemias.[37][38] CLL should not be confused with acute lymphoblastic leukemia, a highly aggressive leukemia most commonly diagnosed in [en.wikipedia.org]
Workup
Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology. Arch Pathol Lab Med. 2017 Feb 22. [Medline]. [Full Text]. [emedicine.medscape.com]
Treatment
A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. [cancer.gov]
The treatment of adult ALL occurs in two phases. The initial treatment phase is called remission induction. [texasoncology.com]
Leukemia Treatment Chronic Myelogenous Leukemia Treatment Hairy Cell Leukemia Treatment Past treatment for cancer and certain genetic conditions affect the risk of having childhood ALL. [uwhealth.org]
Prognosis
[…] expressed Considered worst prognosis of all major ALL subtypes BCR-ABL1 -like 10-25% of all ALL cases CD19, CD10 positivity Poor prognosis Higher risk of MRD t(v;11q23.3) KMT2A ( MLL ) rearranged Most common in infants Becomes increasingly common in [arupconsult.com]
Factors Affecting Prognosis As with any cancer, prognosis (chance of recovery) and long-term survival can vary greatly. [dana-farber.org]
Subtyping helps determine the prognosis and most appropriate treatment in treating ALL. [wiki.clinicalflow.com]
Home Journal of Cancer 2015 Volume 6 Number 11 Na Xu1*, Yu-ling Li1*, Xuan Zhou1, Rui Cao1, Huan Li1, Qi-si Lu1, Lin Li1, Zi-yuan Lu1, Ji-xian Huang1, Jing Sun1, Qi-fa Liu1, Qing-feng Du1,2,, Xiao-li Liu1 CDKN2 Gene Deletion as Poor Prognosis Predictor [free-journal.umm.ac.id]
ALL subtype: The subtype of T cell or B cell affects prognosis. Patients with T-cell ALL tend to have a better prognosis than those with mature B-cell ALL. [physio-pedia.com]
Etiology
Etiology Most cases show chromosomal and genetic abnormalities, occurring spontaneously in genes playing important regulatory roles in controlling the lymphoid cell population. [orpha.net]
Etiology A review of the genetics, cell biology, immunology, and epidemiology of childhood leukemia by Greaves concluded that B-cell precursor acute lymphoblastic leukemia (ALL) has a multifactorial etiology, with a two-step process of genetic mutation [emedicine.medscape.com]
Etiology/Causes [1] [2] [4] The exact causes are unknown. However, there are some risk factors thought to be linked to ALL. [physio-pedia.com]
Etiology Acute lymphoblastic leukemia ( ALL ) No identifiable cause or risk factors in most cases Prior bone marrow damage due to alkylating chemotherapy or ionizing radiation Adult T-cell leukemia / lymphoma is linked to infection with HTLV. [3] [4] [amboss.com]
Granulocytopenia or neutropenia can lead to a high risk of infections, including those of bacterial, fungal, and viral etiologies. Patients may present with fevers and a severe and/or recurrent infection. [msdmanuals.com]
Epidemiology
Epidemiological studies have associated leukemia with workplace exposure to chemicals, but these studies are not as conclusive. [wiki.clinicalflow.com]
Summary Epidemiology About 3,000 children in the United States and 5,000 children in Europe are diagnosed with ALL per year. Clinical description The peak incidence occurs between 2 and 5 years of age. [orpha.net]
The overall survival rate for ALL in 2009–2015 was 68.6%, according to the Surveillance, Epidemiology, and End Results Program (SEER). [medicalnewstoday.com]
The presence of Philadelphia chromosome does not confer poor prognosis in adult pre-B acute lymphoblastic leukaemia in the tyrosine kinase inhibitor era - a surveillance, epidemiology, and end results database analysis. [emedicine.medscape.com]
Pathophysiology
Etiology : mostly occurs after initiating cytotoxic treatment of ALL, AML, or NHL Pathophysiology : tumor cell lysis release of intracellular components (e.g., K , PO 4 3-, nucleic acid ) into the bloodstream Hyperkalemia Hyperphosphatemia : PO 4 3- binds [amboss.com]
Pathophysiology The cells of origin in most patients with CLL are clonal B cells arrested in the B-cell differentiation pathway, intermediate between pre-B cells and mature B cells. [emedicine.medscape.com]
New insights into the pathophysiology and therapy of adult acute lymphoblastic leukemia. Cancer 2015; 121: 2517–2528. [PubMed] [Google Scholar] Shah A, John BM, Sondhi V. Acute lymphoblastic leukemia with treatment—naive Fanconi anemia. [ncbi.nlm.nih.gov]
Prevention
Patients with acute lymphoblastic leukemia (ALL) may be able to help prevent the disease by not smoking. [cancer.osu.edu]
Intrathecal chemotherapy is chemotherapy that is injected into the spinal fluid to prevent or treat leukemia in the brain and spinal cord. [chop.edu]
B and T cells play active roles in preventing the body from infections and germs and destroying cells that have already become infected. B cells particularly help prevent germs from infecting the body while T cells destroy the infected cells. [cancercenter.com]
How can I prevent ALL? In most ALL cases, we don’t know the cause of the diagnosis. Thus, there aren’t any ways to prevent ALL from developing. [oncolink.org]