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Acute Lymphocytic Leukemia: Learning Objectives

Medical Importance

The acute leukemias are aggressive malignancies that originate in a hematopoietic stem cell and are rapidly fatal without immediate treatment. Although acute lymphocytic 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

  1. Identify the age and gender distribution of patients with ALL.
  2. Name common symptoms/signs and common laboratory findings in a patient presenting with ALL.
  3. Briefly describe two tests that can be used to distinguish leukemic blast cells of ALL from leukemic blast cells of AML.
  4. 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.
  5. Describe one complication that leads to mortality in ALL.