Acute lymphoid leukemia in Child
Alerts and Notices
Synopsis
Diagnosis usually requires the presence of over 20% lymphoblasts in the peripheral blood and/or the presence of bone marrow or tissue infiltrate of immature cells with confirmation of lymphoid lineage by flow cytometry and/or cytochemistry.
ALL / LBL is the most common cancer in children (mostly younger than 6 years and accounting for a quarter of all childhood malignancies) and is also seen in adults (usually older than 60 years). Children may present with unexplained fevers, pallor, hepatosplenomegaly, lymphadenopathy, and/or bleeding and easy bruising. Retinal hemorrhage may occur. The cause of ALL / LBL is unknown, but it has been associated with ionizing radiation as well as certain genetic abnormalities. The Philadelphia chromosome (Ph), while rare in childhood cases of ALL, is present in 20%-25% of adult cases, the most common genetic subgroup. The incidence increases with age.
Codes
ICD10CM:C91.00 – Acute lymphoblastic leukemia not having achieved remission
SNOMEDCT:
91857003 – Acute lymphoid leukemia, disease
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Acute myeloid leukemia
- Myelodysplastic syndrome causing pancytopenia
- Lymphomas such as marginal zone lymphoma, chronic lymphocytic leukemia, or mantle cell lymphoma presenting with leukocytosis; hairy cell leukemia; Hodgkin lymphoma (similar young adult age group), T-cell lymphomas
- Viral illness (eg, human immunodeficiency virus, infectious mononucleosis)
- Thymoma
- Aplastic anemia
- Pertussis
- Tuberculosis
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:03/15/2019
Last Updated:07/05/2022
Last Updated:07/05/2022
Acute lymphoid leukemia in Child