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Leukemia, Acute Lymphoblastic (ALL) in Adults

Afsha Rais, MD, Nivas Govindarajan, B.S., M.D. and Niyomi De Silva, MD Reviewed 06/2022
 


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 CTX, given with CNS prophylaxis at intervals throughout therapy:

    • Induction, consolidation, prolonged maintenance

MEDICATION

  • Induction: Goal is to achieve complet...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Inpatient admission during induction CTX for continuous infusion and monitoring of complications

  • Weekly clinic visits with remission consolidatio...

REFERENCES

1
Kantarjian  HM, O’Brien  S, Smith  TL, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol. ...

ADDITIONAL READING

Davis AS, Viera AJ, Mead MD. Leukemia: an overview for primary care. Am Fam Physician. 2014 May 1;89(9):731-8.  

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.

  • Hyper-CVAD is the main therapy.

  • Treatment at an appropriate cancer center for tailo...

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