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General Medicine

Leukemia, Acute Lymphoblastic (ALL) in Adults

Afsha Rais Kaisani, FAAFP, MD and Tasaduq Hussain Mir, FAAFP, MD Reviewed 04/2024
 


BASICS

ALL results from abnormal proliferation of hematopoietic stem cells in the bone marrow (1). 

DESCRIPTION

Acute lymphoblastic leukemia (ALL) in adults is the result of a clonal proliferation, sur...

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

  • Treatment of ALL determined by patient's age and presence of Philadelphia chromosome

  • Three phases to CTX, given with CNS prophylaxis: induction, consolidation, prolonged maint...

ONGOING CARE

Patients on CTX and radiation: annual physical, eye and dental exam; CXR, pulmonary function test and audiometry as needed; baseline ECG every 2-5 years based on CTX used. 

FOLLOW-UP RECOMMENDATIONS

REFERENCES

1
Gbenjo JTC; McCrary GLM, Wilson SE. Leukemia: What Primary Care Physicians Need to Know. Am Fam Physician. 2023;107(4):397-405.
2
Paul S, Kantarjian H, Jabbour EJ. Adult Acute Lymphoblastic ...

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

SNOMED

  • 91857003 Acute lymphoi...

CLINICAL PEARLS

  • ALL diagnosis is based on the presence of lymphoblasts or characteristic mutations in the bone marrow.

  • HCVAD is the main therapy.

  • Treatment at an appropriate cancer center for tailored t...

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Related Images
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<bold>FIGURE 20-54. Acute lymphoblastic leukemia.</bold> The lymphoblasts in peripheral blood contain irregular and indented nuclei with prominent nucleoli and a moderate amount of cytoplasm.

 

<bold>FIGURE 20-54. Acute lymphoblastic leukemia.</bold> The lymphoblasts in peripheral blood contain irregular and indented n...

Acute lymphoblastic leukemia (L2 ALL). The lymphoblasts in the peripheral blood contain irregular and indented nuclei with prominent nucleoli and a moderate amount of cytoplasm.

 

Acute lymphoblastic leukemia (L2 ALL). The lymphoblasts in the peripheral blood contain irregular and indented nuclei with prominent nucle...

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