Medical Importance
The acute leukemias are aggressive malignancies that originate in a
hematopoietic stem cell and are rapidly fatal without immediate
treatment. Although acute lymphoblastic leukemia (ALL) remains a
devastating illness, a significant portion of patients can now be cured
with intensive chemotherapy. Childhood ALL is the most common
malignancy of children and approximately 80 percent of patients will be
cured. Unfortunately, only 30-40 percent of adults with ALL will be
cured. The difference in outcome can be attributed in large part to the
higher frequency of adverse genetic abnormalities in the leukemic cells
of adults with ALL. Early recognition and diagnosis of ALL, and an
appreciation of its complications, will lead to timely supportive
interventions and the potential for curative therapy.
Objectives
- Identify the age and gender distribution of patients with ALL.
- Name common symptoms/signs and common laboratory findings in a patient presenting with ALL.
- Briefly describe two tests that can be used to distinguish leukemic blast cells of ALL from leukemic blast cells of AML.
- Therapy
of ALL commonly consists of an induction phase, post-remission therapy
(consolidation and maintenance therapy), and central nervous system
prophylaxis. Describe the goals of each of these three elements of
therapy.
- Describe one complication that leads to mortality in ALL.
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