Acute Lymphoblastic Leukaemia (ALL)/ Lymphoma
Definition
Malignant proliferation of immature B or T cells, with marrow failure and tissue infiltration
Risk Factors
Genetics
Environment: Radiation during pregnancy, Down's syndrome
Epidemiology
Most common cancer of childhood, rare in adults
Clinical Features
Triad: Weight Loss, Fever, Sweats
Marrow failure: anaemia, infection (dec WCC), bleeding (dec platelets)
Infiltration: CNS involvement (eg cranial nerve palsies, meningism), hepatosplenomegaly, lymphadenopathy
Investigations
Blood: Blood film (blast cells), FBC (hi WCC usually)
Imaging: CXR/ CT (mediastinal/ abdominal lymphadenopathy)
Others: LP (CNS involvement)
Management
Prognosis
Cure rates 70-90% for children, 40% adults
Source
OHCM 9th Ed 2014
Malignant proliferation of immature B or T cells, with marrow failure and tissue infiltration
Risk Factors
Genetics
Environment: Radiation during pregnancy, Down's syndrome
Epidemiology
Most common cancer of childhood, rare in adults
Clinical Features
Triad: Weight Loss, Fever, Sweats
Marrow failure: anaemia, infection (dec WCC), bleeding (dec platelets)
Infiltration: CNS involvement (eg cranial nerve palsies, meningism), hepatosplenomegaly, lymphadenopathy
Investigations
Blood: Blood film (blast cells), FBC (hi WCC usually)
Imaging: CXR/ CT (mediastinal/ abdominal lymphadenopathy)
Others: LP (CNS involvement)
Management
- Supportive: transfusion, allopurinol (prevent TLS), prevent effects of neutropaenia
- Chemo
- Others: CNS prophylaxis (methotrexate/ irradiation)
- Upon 1st remission, match related allogenic marrow transplantations
Prognosis
Cure rates 70-90% for children, 40% adults
Source
OHCM 9th Ed 2014