Acute lymphocytic leukemia (ALL)

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Bone marrow aspiration

Acute lymphocytic leukemia - photomicrograph

Auer rods

Bone marrow from hip

Immune system structures

Acute lymphocytic leukemia (ALL)

Alternative Names:

ALL; Acute childhood leukemia; Cancer - acute childhood leukemia (ALL); Leukemia - acute childhood (ALL)
Symptoms:

Prolonged or excessive bleeding, bruising easily
Bleeding gums
Nosebleeds
Bleeding into the skin
Menstrual irregularities
Skin rash or lesion
- Pinpoint red spots (petechiae)
- Bruises (ecchymoses )
Paleness
Fatigue
Infection
Sternal tenderness
Bone pain or tenderness
- Breastbone (sternum)
Joint pain
- Hip pain
- Knee pain
- Ankle pain
- Foot pain over small joints of the foot
- Shoulder pain
- Elbow pain
- Wrist pain
- Hand pain over small joints of the hand
Lymphadenopathy (enlarged glands)
Unintentional weight loss
Fever
Swollen gums
Shortness of breath (made worse by exercise)
Sensations of feeling the heart beat (palpitations ) with an irregular pattern

Signs and tests:

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A physical exam and lab tests may reveal the following:

Enlarged liver and spleen
Bruising (ecchymosis)
Evidence of bleeding (petechiae, purpura)
Abnormal WBC count
A CBC shows anemia
Low platelet count
A bone marrow aspiration shows an increased number of cells (hypercellularity) and an increase in lymphoblasts.

ALL may also alter the results of the following tests:

Classification of ALL now depends on a number of sophisticated tests, such as immunophenotyping, karyotyping, and terminal deoxynucleotidyltransferase (TdT) activity. The combined results of these tests allows pinpoint molecular diagnosis, which helps guide the treatment decisions, and clarify the likely prognosis.

For instance, the cells of some leukemias contain chromosomal abnormalities. Those with the Philadelphia chromosome or with the t(4;11) translocation would tend to have a poor prognosis, thus intensive treatment and an early bone marrow transplant might be recommended immediately. Other genes (such as the TEL/AML1 rearrangement) can indicate a very favorable prognosis.