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Lecture notes

Acute and chronic lymphoblastic leukaemia

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This document contains all the relevant student knowledge pertaining to acute and chronic lymphoblastic leukaemia. It includes: Definition Pathophysiology Symptoms Investigations and diagnosis Medical management

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  • December 18, 2022
  • 9
  • 2022/2023
  • Lecture notes
  • Caitlin austin
  • All classes

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Acute Chronic
Lymphoblastic


Myeloid Myeloid




Aetiology Unknown with noted factors
Genetic factors
Environmental Radiation exposure and smoking
Viral infection
Hx of malignancy


Pathophysiology
In Acute lymphocytic leukaemia ALL genetic alteration
of a lymphoid progenitor cell results in uncontrollable proliferation
and clonal expansion The leukaemia blasts infiltrate the bone
marrow and other organs leading to loss of normal function
Pht All t
NB Philadelphia chromosome present in around
25 of ALL Ph chromosome leads to a fusion called BCR ABLE
Production of Tyrosine Kinase causing the cells to grow and
proliferate

, Diagnostic Approach
A Definitive diagnosis Bone marrow aspirate and biopsy
Demonstrating hypercellularity and infiltration by leukaemia
lymphoblasts At least 20 lymphoblasts in the bone marrow is
required for diagnosis
Most commonly adult ALL presents as an acute disease


B History
Commonly signs will present only a few weeks
prior to
diagnosis and are associated with cytopenias
Anaemia Fatigue dyspnea palpitations and dizziness
Thrombocytopenia Bleeding e.g Epistaxis menorrhagia and easy
bruising
Neutropenia Recurrent infection
Enlarged lymphnodes General presenting feature
Abdominal bone pain may present due to infiltration of
blast cells into the spleen bone marrow


C Physical exam

Pallor Ecchymosis
Petechiae lymphadenopathy
Abdo testicular masses
T ALL
May present as a mediastinal mass
Fever sweats
night

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