Acute lymphocytic leukemia: Difference between revisions
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== Background == | ==Background == | ||
*Characterized by proliferation of immature lymphoblast( >20% in periphery) | *Characterized by proliferation of immature lymphoblast( >20% in periphery) | ||
*Less than 20% of acute leukemias in adults, | *Less than 20% of acute leukemias in adults, | ||
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*Highest incidence in 7th decade of life | *Highest incidence in 7th decade of life | ||
== Clinical Features == | ==Clinical Features == | ||
*Lymphocytosis, neutropenia, anemia, thrombocytopenia, | *Lymphocytosis, neutropenia, anemia, thrombocytopenia, | ||
*Lymphadenopathy, hepatosplenomegaly | *Lymphadenopathy, hepatosplenomegaly | ||
*CNS and testes involvement common | *CNS and testes involvement common | ||
== Differential Diagnosis == | ==Differential Diagnosis == | ||
{{Leuk/lymph DDX}} | {{Leuk/lymph DDX}} | ||
== Diagnosis == | ==Diagnosis == | ||
*CXR | *CXR | ||
*CBC with peripheral smear | *CBC with peripheral smear | ||
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*Get extra purple top for flow cytometry, especially before transfusion | *Get extra purple top for flow cytometry, especially before transfusion | ||
== Treatment == | ==Treatment == | ||
*Aggressive IV hydration | *Aggressive IV hydration | ||
*If febrile, complete cultures and broad spectrum antibiotics | *If febrile, complete cultures and broad spectrum antibiotics | ||
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**see [[Tumor Lysis Syndrome]] | **see [[Tumor Lysis Syndrome]] | ||
== See Also == | ==See Also == | ||
*[[Oncologic emergencies]] | *[[Oncologic emergencies]] | ||
*[[Acute leukemia]] | *[[Acute leukemia]] | ||
Revision as of 02:09, 5 July 2016
Background
- Characterized by proliferation of immature lymphoblast( >20% in periphery)
- Less than 20% of acute leukemias in adults,
- Most common form in children (see also Leukemia (Peds))
- Highest incidence in 7th decade of life
Clinical Features
- Lymphocytosis, neutropenia, anemia, thrombocytopenia,
- Lymphadenopathy, hepatosplenomegaly
- CNS and testes involvement common
Differential Diagnosis
Acute Leukemia/Lymphoma
Diagnosis
- CXR
- CBC with peripheral smear
- Chem7, ca, mg, phos, Uric Acid, UA, LDH (to check for Tumor Lysis)
- LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC)
- Get extra purple top for flow cytometry, especially before transfusion
Treatment
- Aggressive IV hydration
- If febrile, complete cultures and broad spectrum antibiotics
- Manage Complications
- see DIC
- see Leukostasis
- see Tumor Lysis Syndrome