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Leukemia, Acute Lymphoblastic (ALL) in Adults

Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Acute lymphoblastic leukemia (ALL) in adults is the result of a clonal proliferation, survival, and impaired differentiation of immature lymphocytes. The World Health Organization (W...

DIAGNOSIS

HISTORY

  • Symptoms arise from sequelae of bone marrow suppression and/or from leukemic cell organ infiltration.

  • B symptoms: fever, weight loss, night sweats

  • Anemia: fatigue, shortness of breath, ...

TREATMENT

GENERAL MEASURES

  • Three phases to treatment:

    • Induction + CNS prophylaxis

    • Consolidation

    • Prolonged maintenance

  • Treatment for initial induction and relapse is changing based on Ph receptor status and...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Ambulatory as tolerated 

Patient Monitoring

  • Requires inpatient admission during induction CTX for continuous infusion and monitoring of metabolic and infectious com...

REFERENCES

1
Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Bl...

CODES

ICD10

  • C91.00 Acute lymphoblastic leukemia not having achieved remission

  • C91.01 Acute lymphoblastic leukemia, in remission

  • C91.02 Acute lymphoblastic leukemia, in relapse

ICD9

  • 204.00 Acute lymphoid le...

CLINICAL PEARLS

  • The diagnosis of ALL is based on the presence of ≥20% (NCCN) or 25% (WHO) lymphoblasts or characteristic mutations in the bone marrow.

  • Hyper-CVAD is still the main therapy; however, new...

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