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Acute lymphoid leukemia in Child
Other Resources UpToDate PubMed

Acute lymphoid leukemia in Child

Contributors: Nina Haghi MD, Carla Casulo MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Acute lymphoblastic leukemia (ALL) / lymphoblastic lymphoma (LBL), also known as acute lymphocytic leukemia / lymphoma or acute lymphoid leukemia, is a cancer of precursor B-cell, T-cell, or other cell types in which immature lymphoid cells accumulate in blood, bone marrow, or other tissue.

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. Approximately 75% of infants with ALL have KMT2A gene rearrangement (formerly known as mixed-lineage leukemia), associated with particularly poor outcomes. 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 of Ph-positive ALL increases with age.


C91.00 – Acute lymphoblastic leukemia not having achieved remission

91857003 – Acute lymphoid leukemia, disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Acute myeloid leukemia
  • Myelodysplastic syndromes causing pancytopenia
  • Lymphomas such as Nodal 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 disease, infectious Mononucleosis)
  • Thymoma
  • Aplastic anemia
  • Pertussis
  • Tuberculosis

Best Tests

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Management Pearls

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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.

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Last Reviewed:03/15/2019
Last Updated:05/09/2023
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Acute lymphoid leukemia in Child
A medical illustration showing key findings of Acute lymphoid leukemia : Fatigue, Fever, Hepatosplenomegaly, Skin petechiae, Bone pain, Easy bruising, Lymphadenopathy, Neutropenia, Dyspnea, Anemia, Pallor, Thrombocytopenia
Clinical image of Acute lymphoid leukemia - imageId=5055900. Click to open in gallery.  caption: 'A deep patterned ulcer with a pink, rolled border on the buttock.'
A deep patterned ulcer with a pink, rolled border on the buttock.
Copyright © 2024 VisualDx®. All rights reserved.