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__NOTOC__
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{{Acute lymphoblastic leukemia}}
{{Acute lymphoblastic leukemia}}
 
{{CMG}} {{AE}} {{RT}} {{CLG}}
{{CMG}} {{AE}} {{RT}}


==Overview==
==Overview==
 
[[Symptoms]] of acute lymphoblastic leukemia include generalized weakness and [[fatigue (physical)|fatigue]], frequent or unexplained [[fever]] and [[infection]]s, [[weight loss]] and/or [[loss of appetite]], excessive [[bruising]], [[hemorrhage|bleeding]] from wounds, [[nosebleed]]s, [[petechiae]], [[bone pain]], [[joint pain]]s and [[dyspnea]].
==History==
==History==
Patients with acute lymphoblastic leukemia may have a positive history of:<ref name="pmid18569840">{{cite journal |vauthors=Bakhshi S, Padmanjali KS, Arya LS |title=Infections in childhood acute lymphoblastic leukemia: an analysis of 222 febrile neutropenic episodes |journal=Pediatr Hematol Oncol |volume=25 |issue=5 |pages=385–92 |date=June 2008 |pmid=18569840 |doi=10.1080/08880010802106564 |url=}}</ref><ref name="pmid10472550">{{cite journal |vauthors=Sutor AH, Mall V, Thomas KB |title=Bleeding and thrombosis in children with acute lymphoblastic leukaemia, treated according to the ALL-BFM-90 protocol |journal=Klin Padiatr |volume=211 |issue=4 |pages=201–4 |date=1999 |pmid=10472550 |doi=10.1055/s-2008-1043788 |url=}}</ref><ref name="pmid22543829">{{cite journal |vauthors=Steele M, Narendran A |title=Mechanisms of defective erythropoiesis and anemia in pediatric acute lymphoblastic leukemia (ALL) |journal=Ann. Hematol. |volume=91 |issue=10 |pages=1513–8 |date=October 2012 |pmid=22543829 |doi=10.1007/s00277-012-1475-5 |url=}}</ref><ref name="pmid28665419">{{cite journal |vauthors=Terwilliger T, Abdul-Hay M |title=Acute lymphoblastic leukemia: a comprehensive review and 2017 update |journal=Blood Cancer J |volume=7 |issue=6 |pages=e577 |date=June 2017 |pmid=28665419 |pmc=5520400 |doi=10.1038/bcj.2017.53 |url=}}</ref><ref name="pmid26917658">{{cite journal |vauthors=Shephard EA, Neal RD, Rose PW, Walter FM, Hamilton W |title=Symptoms of adult chronic and acute leukaemia before diagnosis: large primary care case-control studies using electronic records |journal=Br J Gen Pract |volume=66 |issue=644 |pages=e182–8 |date=March 2016 |pmid=26917658 |pmc=4758497 |doi=10.3399/bjgp16X683989 |url=}}</ref>
*[[Infection]]
*[[Bleeding]]
*[[Anemia]]
*[[Easy bruising]]


===Symptoms===
== Symptoms ==


Initial symptoms are not specific to ALL, but worsen to the point that medical help is sought. The signs and symptoms of ALL are variable but follow from bone marrow replacement and / or organ infiltration.
===Common symptoms===
Common [[symptoms]] of acute lymphoblastic leukemia include the following:<ref name="pmid27647842">{{cite journal |vauthors=Clarke RT, Van den Bruel A, Bankhead C, Mitchell CD, Phillips B, Thompson MJ |title=Clinical presentation of childhood leukaemia: a systematic review and meta-analysis |journal=Arch. Dis. Child. |volume=101 |issue=10 |pages=894–901 |date=October 2016 |pmid=27647842 |doi=10.1136/archdischild-2016-311251 |url=}}</ref><ref name="pmid4059858">{{cite journal |vauthors=Vesterby A, Myhre Jensen O |title=Aseptic bone/bone marrow necrosis in leukaemia |journal=Scand J Haematol |volume=35 |issue=3 |pages=354–7 |date=September 1985 |pmid=4059858 |doi= |url=}}</ref><ref name="pmid18157042">{{cite journal |vauthors=Sinigaglia R, Gigante C, Bisinella G, Varotto S, Zanesco L, Turra S |title=Musculoskeletal manifestations in pediatric acute leukemia |journal=J Pediatr Orthop |volume=28 |issue=1 |pages=20–8 |date=2008 |pmid=18157042 |doi=10.1097/BPO.0b13e31815ff350 |url=}}</ref><ref name="pmid19100362">{{cite journal |vauthors=Pui CH |title=Acute lymphoblastic leukemia: introduction |journal=Semin. Hematol. |volume=46 |issue=1 |pages=1–2 |date=January 2009 |pmid=19100362 |pmc=2638983 |doi=10.1053/j.seminhematol.2008.09.011 |url=}}</ref><ref name="pmid28665419">{{cite journal |vauthors=Terwilliger T, Abdul-Hay M |title=Acute lymphoblastic leukemia: a comprehensive review and 2017 update |journal=Blood Cancer J |volume=7 |issue=6 |pages=e577 |date=June 2017 |pmid=28665419 |pmc=5520400 |doi=10.1038/bcj.2017.53 |url=}}</ref>


* Generalised weakness and [[Fatigue (physical)|fatigue]]
* Generalized weakness and [[Fatigue (physical)|fatigue]]
* [[Anemia]]
* [[Anemia]]
* Frequent or unexplained [[fever]] and [[infection]]s
* Frequent or unexplained [[fever]] and [[infection]]s
* Weight loss and/or loss of appetite
* [[Weight loss]]
* Excessive [[bruising]] or [[hemorrhage|bleeding]] from wounds, [[nosebleed]]s, [[petechiae]] (red pinpoints on the skin)
* [[Anorexia]]
* [[Bone pain]], [[joint pain]]s (caused by the spread of "blast" cells to the surface of the bone or into the joint from the marrow cavity)
* [[Bleeding|Excessive bleeding from minor wounds]]
* [[Breathlessness]]
* [[Bone pain]]
* Enlarged [[lymph nodes]], [[liver]] and/or [[spleen]]
* [[Dyspnea]]  
 
* [[Bruising|Excessive bruising]]
The signs and [[symptoms]] of ALL result from the lack of normal and healthy blood cells because they are crowded out by malignant and immature [[leukocytes]] (white blood cells). Therefore, people with ALL experience symptoms from malfunctioning of their [[erythrocytes]] (red blood cells), leukocytes, and platelets not functioning properly. Laboratory tests which might show abnormalities include [[blood count]] tests, [[renal function]] tests, [[electrolyte]] tests and [[liver enzyme]] tests.
* [[Petechiae]]
===Less common symptoms===
* [[Epistaxis]]<ref name="AboudTreleaven1991">{{cite journal|last1=Aboud|first1=H.|last2=Treleaven|first2=J.|last3=Carter|first3=R.|last4=O'Brien|first4=M.|last5=Powels|first5=R.|title=An adult with common acute lymphoblastic leukaemia (C-ALL) presenting with skin infiltration|journal=British Journal of Dermatology|volume=124|issue=1|year=1991|pages=84–85|issn=0007-0963|doi=10.1111/j.1365-2133.1991.tb03287.x}}</ref>
*[[Arthralgia]] (caused by the spread of "blast" [[Cell (biology)|cells]] to the surface of the [[bone]] or into the joint from the [[Bone marrow|marrow]] cavity)<ref name="pmid26216831">{{cite journal| author=Brix N, Rosthøj S, Herlin T, Hasle H| title=Arthritis as presenting manifestation of acute lymphoblastic leukaemia in children. | journal=Arch Dis Child | year= 2015 | volume= 100 | issue= 9 | pages= 821-5 | pmid=26216831 | doi=10.1136/archdischild-2014-307751 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26216831  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Lymphocytic leukemia]]
[[Category:Leukemia]]


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[[Category:Up-To-Date]]
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[[Category:Immunology]]

Latest revision as of 23:02, 13 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Carlos A Lopez, M.D. [3]

Overview

Symptoms of acute lymphoblastic leukemia include generalized weakness and fatigue, frequent or unexplained fever and infections, weight loss and/or loss of appetite, excessive bruising, bleeding from wounds, nosebleeds, petechiae, bone pain, joint pains and dyspnea.

History

Patients with acute lymphoblastic leukemia may have a positive history of:[1][2][3][4][5]

Symptoms

Common symptoms

Common symptoms of acute lymphoblastic leukemia include the following:[6][7][8][9][4]

Less common symptoms

References

  1. ↑ Bakhshi S, Padmanjali KS, Arya LS (June 2008). "Infections in childhood acute lymphoblastic leukemia: an analysis of 222 febrile neutropenic episodes". Pediatr Hematol Oncol. 25 (5): 385–92. doi:10.1080/08880010802106564. PMID 18569840.
  2. ↑ Sutor AH, Mall V, Thomas KB (1999). "Bleeding and thrombosis in children with acute lymphoblastic leukaemia, treated according to the ALL-BFM-90 protocol". Klin Padiatr. 211 (4): 201–4. doi:10.1055/s-2008-1043788. PMID 10472550.
  3. ↑ Steele M, Narendran A (October 2012). "Mechanisms of defective erythropoiesis and anemia in pediatric acute lymphoblastic leukemia (ALL)". Ann. Hematol. 91 (10): 1513–8. doi:10.1007/s00277-012-1475-5. PMID 22543829.
  4. ↑ 4.0 4.1 Terwilliger T, Abdul-Hay M (June 2017). "Acute lymphoblastic leukemia: a comprehensive review and 2017 update". Blood Cancer J. 7 (6): e577. doi:10.1038/bcj.2017.53. PMC 5520400. PMID 28665419.
  5. ↑ Shephard EA, Neal RD, Rose PW, Walter FM, Hamilton W (March 2016). "Symptoms of adult chronic and acute leukaemia before diagnosis: large primary care case-control studies using electronic records". Br J Gen Pract. 66 (644): e182–8. doi:10.3399/bjgp16X683989. PMC 4758497. PMID 26917658.
  6. ↑ Clarke RT, Van den Bruel A, Bankhead C, Mitchell CD, Phillips B, Thompson MJ (October 2016). "Clinical presentation of childhood leukaemia: a systematic review and meta-analysis". Arch. Dis. Child. 101 (10): 894–901. doi:10.1136/archdischild-2016-311251. PMID 27647842.
  7. ↑ Vesterby A, Myhre Jensen O (September 1985). "Aseptic bone/bone marrow necrosis in leukaemia". Scand J Haematol. 35 (3): 354–7. PMID 4059858.
  8. ↑ Sinigaglia R, Gigante C, Bisinella G, Varotto S, Zanesco L, Turra S (2008). "Musculoskeletal manifestations in pediatric acute leukemia". J Pediatr Orthop. 28 (1): 20–8. doi:10.1097/BPO.0b13e31815ff350. PMID 18157042.
  9. ↑ Pui CH (January 2009). "Acute lymphoblastic leukemia: introduction". Semin. Hematol. 46 (1): 1–2. doi:10.1053/j.seminhematol.2008.09.011. PMC 2638983. PMID 19100362.
  10. ↑ Aboud, H.; Treleaven, J.; Carter, R.; O'Brien, M.; Powels, R. (1991). "An adult with common acute lymphoblastic leukaemia (C-ALL) presenting with skin infiltration". British Journal of Dermatology. 124 (1): 84–85. doi:10.1111/j.1365-2133.1991.tb03287.x. ISSN 0007-0963.
  11. ↑ Brix N, Rosthøj S, Herlin T, Hasle H (2015). "Arthritis as presenting manifestation of acute lymphoblastic leukaemia in children". Arch Dis Child. 100 (9): 821–5. doi:10.1136/archdischild-2014-307751. PMID 26216831.

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