Acute lymphoid leukemia in Child
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
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)
- Aplastic anemia
Drug Reaction Data