Acute lymphoblastic leukaemia (ALL)

• What is the most common childhood malignancy?

  ALL
• What sex is ALL more common in?

  Males
• Some are some factors that may contribute to the development of ALL?

  Genetics

  Viral exposure

  Environment - smoking/radiation exposure
• How may a patient with ALL present?

  Organomegaly - hepato/splenomegaly

  Weight loss

  Lymphadenopathy

  Unusual bleeding/bruising - thrombocytopenia

  Bone pain
• What is the first-line investigation for ALL?

  FBC with a differential
• What will the blood tests for ALL show?

  Thrombocytopenia

  Anaemia

  WBC - can be either low or high
• What are some other investigations required in any case presenting with ALL and why are they done?

  Infection screen

  Coag profile

  U&Es

  Lactate

  Uric acid

  Why: Identify any complications that need immediate attention
• What is needed to be examined for the diagnosis of ALL?

  Peripheral blood smear

  Bone marrow aspiration
• How is ALL managed in phases?

  Induction

  Consolidation

  Maintenance
• What is the induction phase of ALL management?

  Eradicate leukaemic cells to <5%
• What is the consolidation phase of ALL management?

  Prevent growth of leukaemia from residual cells
• What is the maintenance phase of ALL management?

  Chemotherapy to prevent relapse