Acute lymphoblastic leukemia overview: Difference between revisions
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The overall cure rate in children is 85% and about 50% of adults have long-term disease-free survival. Advancements in medical [[Medical technology|technology]] and [[research]] over the past four decades in the treatment of Acute lymphocytic leukemia has improved the overall prognosis significantly from a 0 to 20-75% survival rate. The prognosis for Acute Lymphoblastic leukemia differs between individuals depending on a wide variety of factors like gender, ethnicity, age at diagnosis, morphological, immunological, and genetic subtypes [[Genetic disorder]]s response of patient to initial treatment, central nervous system involvement, celular morphology, chromosomal abnormalities, there are some cytogenetic subtypes have a worse prognosis than others like translocations. The 5-year relative survival of patients with Acute Lymphoblastic leukemia was 70% between 2004 and 2010. | The overall cure rate in children is 85% and about 50% of adults have long-term disease-free survival. Advancements in medical [[Medical technology|technology]] and [[research]] over the past four decades in the treatment of Acute lymphocytic leukemia has improved the overall prognosis significantly from a 0 to 20-75% survival rate. The prognosis for Acute Lymphoblastic leukemia differs between individuals depending on a wide variety of factors like gender, ethnicity, age at diagnosis, morphological, immunological, and genetic subtypes [[Genetic disorder]]s response of patient to initial treatment, central nervous system involvement, celular morphology, chromosomal abnormalities, there are some cytogenetic subtypes have a worse prognosis than others like translocations. The 5-year relative survival of patients with Acute Lymphoblastic leukemia was 70% between 2004 and 2010. | ||
Initial symptoms are not specific to Acute lymphoblastic leukemia, but worsen to the point that medical help is sought. The signs and symptoms are variable like | |||
Generalised weakness and [[Fatigue (physical)|fatigue]], [[Anemia]], frequent or unexplained [[fever]] and [[infection]]s, [[Weight loss]] and/or loss of appetite | |||
Excessive [[bruising]] or [[hemorrhage|bleeding]] from wounds, [[nosebleed]]s, [[petechiae]] (red pinpoints on the skin), [[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) and [[Breathlessness]]. The signs and [[symptoms]] of Acute lymphoblastic leukemia result from the lack of normal and healthy blood cells because they are crowded out by malignant and immature [[leukocytes]]. | |||
The physical examination findings of Acute lymphocytic leukemia are [[Lymphadenopathy]], [[Hepatomegaly]] and [[Splenomegaly]]. | |||
The laboratory findings of Acute lymphoblastic leukemia are [[eosinophilia]], [[lymphocytosis]], [[Red cell production reduced]], [[thrombocytopenia]]. Chemistry panels with altered levels of [[uric acid]], [[creatinine]], [[blood urea nitrogen]], [[potassium]], [[phosphate]], [[calcium]], [[bilirubin]], [[hepatic transaminases]] and [[ferritin]]. A [[lumbar puncture|spinal tap]] will tell if the spinal column and [[central nervous system|brain]] has been invaded. | |||
Revision as of 15:19, 27 August 2015
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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]
Overview
Acute lymphoblastic leukemia is a form of leukemia, or cancer of the white blood cells. Acute refers to the undifferentiated, immature state of the circulating lymphocytes ("blasts") and to the rapid progression of disease, which can be fatal in weeks to months if left untreated.
The classification subtyping of the various forms of Acute limphocytic leukemia used to be done according to the French-American-British (FAB) classification which was used for all Acute leukemias (including acute myelogenous leukemia). As Acute lymphocytic leukemia is not a solid tumour, the TxNxMx notation as used in solid cancers only. The recent World Health Organization International panel on Acute lymphoblastic leukemia recommends that this classification be abandoned, since the morphological classification has no clinical or prognostic relevance. But here you can find both classifications for academic and historic porpouses.
The cause of most Acute lympoblastic leukemias is not known. In leukemias, including Acute lymphoblastic leukemia chromosomal translocations occurs regularly and can trigger oncogenes. Some families have a hereditary predisposition. Acute lymphoblastic leukemia is associated with exposure to radiation in animals and humans. Malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow. There are specific markers for B-cell Acute lymphoblastic leukemia and T-cell Acute lymphoblastic leukemia.
Diagnostic confusion with Acute myelogenous leukemia, hairy cell leukemia, and malignant lymphoma is not uncommon. Proper diagnosis is crucial because of the difference in prognosis and treatment of Acute Lymphoblastic leukemia and Acute Myelogenous leukemia.
American Cancer Society estimated in 2015 that new cases and deaths from Acute lymphocytic leukemia in the United States will be 6,250 and 1,450 respectively. The age-adjusted prevalence of acute lymphoblastic leukemia is 17.4 per 100,000 in 2011. There is an increased incidence in people with Down's Syndrome, Fanconi's anemia, Bloom's syndrome, ataxia-telangiectasia, X-linked agammaglobulinemia and severe combined immunodeficiency. Acute lymphoblastic leukemia accounts for approximately 80 percent of all childhood leukemia cases, making it the most common type of childhood cancer.
There are some risk factors associated with Acute lymphoblastic leukemia like: Down syndrome, Ataxia telangiectasia, Bloom syndrome, X-linked agammaglobulinemia, Fanconi's anemia and Severe combined immunodeficiency.
In Acute lymphoblastic leukemia there are no standard screening tests for leukemia.
The overall cure rate in children is 85% and about 50% of adults have long-term disease-free survival. Advancements in medical technology and research over the past four decades in the treatment of Acute lymphocytic leukemia has improved the overall prognosis significantly from a 0 to 20-75% survival rate. The prognosis for Acute Lymphoblastic leukemia differs between individuals depending on a wide variety of factors like gender, ethnicity, age at diagnosis, morphological, immunological, and genetic subtypes Genetic disorders response of patient to initial treatment, central nervous system involvement, celular morphology, chromosomal abnormalities, there are some cytogenetic subtypes have a worse prognosis than others like translocations. The 5-year relative survival of patients with Acute Lymphoblastic leukemia was 70% between 2004 and 2010.
Initial symptoms are not specific to Acute lymphoblastic leukemia, but worsen to the point that medical help is sought. The signs and symptoms are variable like Generalised weakness and fatigue, Anemia, frequent or unexplained fever and infections, Weight loss and/or loss of appetite Excessive bruising or bleeding from wounds, nosebleeds, petechiae (red pinpoints on the skin), Bone pain, joint pains (caused by the spread of "blast" cells to the surface of the bone or into the joint from the marrow cavity) and Breathlessness. The signs and symptoms of Acute lymphoblastic leukemia result from the lack of normal and healthy blood cells because they are crowded out by malignant and immature leukocytes.
The physical examination findings of Acute lymphocytic leukemia are Lymphadenopathy, Hepatomegaly and Splenomegaly.
The laboratory findings of Acute lymphoblastic leukemia are eosinophilia, lymphocytosis, Red cell production reduced, thrombocytopenia. Chemistry panels with altered levels of uric acid, creatinine, blood urea nitrogen, potassium, phosphate, calcium, bilirubin, hepatic transaminases and ferritin. A spinal tap will tell if the spinal column and brain has been invaded.