Acute Lymphoblastic Leukaemia

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Acute Lymphoblastic Leukaemia

• the common form of leukaemia in children
• incidence highest at 3-7 years, falls off by 10 years
• secondary rise after 40
• divided into B or T types or FAB classification L₁ to L₃

Clinical Features

• bone marrow failure
  • anaemia
  • neutropenia
  • thrombocytopenia
• organ infiltration
  • tender bones
  • lymphadenopathy
  • moderate splenomegaly
  • hepatomegaly
  • meningeal syndrome
  • fundus
    • papilloedema
    • haemorrhage
  • testicular swelling
  • mediastinal compression (T-ALL)

Investigations

• FBC
• Blood Film
• Bone Marrow
  • aspirate
  • trephine
• Lumbar puncture
• Biochemistry
  • Urate
  • LDH
  • hypercalcaemia
• X-rays
  • lytic lesions
  • mediastinal mass

Differential

• Acute Myeloid Leukaemia
• Aplastic anaemia
• marrow infiltration
  • e.g. rhabdomyosarcoma
  • neuroblastoma
  • Ewings Sarcoma
• infections
  • Infectious Mononucleosis
  • Whooping Cough
• Juvenile Idiopathic Arthritis

• Immune Thrombocytopenic Purpura

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