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Acute Lymphocytic Leukemia In Adults

 Syn. Acute Lymphoblastic leukemia , ALL , LBL

Signs & Symptoms

 Purpura
Note: due to Thrombocytopenia, due to Bone marrow involvement, due to induced anemia, due to systemic inflammatory cytokines
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of B cell acute lymphoblastic lymphoma] Harrison [ 758] Epocrates [ ALL: key factors]
Petechiae
Note: due to Thrombocytopenia, due to Bone marrow involvement, due to induced anemia, due to systemic inflammatory cytokines
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of B cell acute lymphoblastic lymphoma] Harrison [ 758] Epocrates [ ALL: key factors]
Unintentional weight loss
Note: due to Systemic inflammatory cytokines ,due to infections
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of T cell acute lymphoblastic lymphoma] Epocrates [ ALL: key factors]
Lymphoblasts infiltration of bone marrow #criteria
Note: At list 20% infiltration of bone marrow biopsy/aspiration. in 70% of patients bone marrow is involved more than 90% with blasts
Ref: Harrison [ 758] Epocrates [ ALL: tests]

Physical Examination

Lab / Serology

 Circulating lymphoblasts
Note: due to Infiltration of bone marrow with lymphocytic leukemic cells, Not sufficient to establish diagnosis
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of T cell acute lymphoblastic lymphoma] Harrison [ 758] Epocrates [ ALL: tests]
Thrombocytopenia
Note: due to Infiltration of bone marrow with lymphocytic leukemic cells, Platelete count less than 20000(severe thrombocytopenia) is seen in one-fifth of patients
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of T cell acute lymphoblastic lymphoma] Harrison [ 758] Epocrates [ ALL: tests]
Decreased reticulocyte count
Note: due to Infiltration of bone marrow with lymphocytic leukemic cells
Ref: Epocrates [ ALL: tests]

Imagin Study

 Central nervous system bleeding
Ref: Epocrates [ ALL:key factors]
Central nervous system infiltration
Ref: Epocrates [ ALL:key factors]
Widened mediastinum
Note: due to Mediastinal lymphadenopathy
Ref: Epocrates [ ALL:key factors]

Complication

 Decreased reticulocyte count
Note: due to Infiltration of bone marrow with lymphocytic leukemic cells
Ref: Epocrates [ ALL: tests]
Thrombocytopenia
Note: due to Infiltration of bone marrow with lymphocytic leukemic cells, Platelete count less than 20000(severe thrombocytopenia) is seen in one-fifth of patients
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of T cell acute lymphoblastic lymphoma] Harrison [ 758] Epocrates [ ALL: tests]
Mediastinal mass #T_cell_ALL, #LBL
Note: More commonly caused by T-ALL
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of T cell acute lymphoblastic lymphoma] Epocrates [ ALL:other factors]

Risk Factors

 White race
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of B cell acute lymphoblastic lymphoma]
Smoking
Ref: Uptodate [ Clinical manifestations,pathologic features,and diagnosis of B cell acute lymphoblastic lymphoma]

Cause

 Adult T-cell leukemia
Note: Adult T-cell leukemia/lymphoma
Ref: Harrison [ 757] Epocrates [ ALL-etiology]
Human T-cell leukemia virus I
Note: Adult T-cell leukemia/lymphoma
Ref: Harrison [ 757] Epocrates [ ALL-etiology]
Burkitt lymphoma
Note: Burkitt lymphoma
Ref: Harrison [ 758] Epocrates [ ALL-etiology]

Other