Acute Lymphoblastic Leukemia - Diagnosis and Staging

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Last Updated on Apr 04, 2018
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Diagnosis and Staging

Diagnosis of Acute Lymphoblastic Leukemia (ALL) is established by using simple blood tests and this is followed by bone marrow test or genetic tests to stage the cancer.

  • First and foremost, blood tests are carried out to diagnose or rule out ALL. Some of the parameters studied are:
  1. Total blood Count
  2. Different types of blood cells and their count (Differential count)
  3. Hemoglobin level
  4. Blood cell morphology
  5. Immunocytochemistry
  6. Blood biochemical parameters like electrolytes, Sugars, Creatinine, Urea or BUN, Liver Function Test.
  7. A bone marrow sample is obtained from the pelvic bone using special needles. Various specialists scrutinize the marrow sample to confirm the diagnosis, to categorize and stage the disease and also to decide on the treatment regimen.
  8. A lumbar puncture (or spinal tap) may be carried out to see if there are malignant cells in the cerebro-spinal fluid.
  9. Cytogenetic tests such as a Karyotype or Fluorescent In Situ Hybridization (FISH) may be carried out to identify the chromosomal changes, such as translocations.
  10. Cytogenetic abnormalities occur in approximately 70% of ALL cases in adults.
  11. These abnormalities included balanced translocations as occurs in cases of AML.
  12. However, abnormalities of chromosome number (hypodiploidy, hyperdiploidy) are much more common in ALL than in AML.

Based on the various diagnostic tests, doctors may categorize ALL into six groups. This staging plays a major role in deciding the treatment protocol for affected patients and to also decide on the prognosis.

The stages of ALL include:

  • Early pre-B ALL
  • Common ALL
  • Pre-B-cell ALL
  • Mature B-cell ALL (Burkitt leukemia)
  • Pre-T-cell ALL
  • Mature T-cell ALL

References:

  1. Pui CH. Acute lymphoblastic leukemia. Pediatr Clin North Am 1997; 4: 831-846.
  2. Pui CH, Evans WE. Acute lymphoblastic leukemia. N Engl J Med 1998; 339: 605-615.
  3. Gurney JG, Severson RK, Davis S, Robinson L. Incidence of cancer in children in the United States. Cancer 1995; 75: 2186-2195.
  4. Young J, Gloeckler RL, Silverberg E, Horm J, Miller R. Cancer incidence, survival and mortality for children younger than age 15 years. Cancer 1986; 58: 598-602.

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hi my daughter , rashmi 5 year old female was admitted in a hospital with the c/o fever,and anemia diagnosed as a ALL ,B CELL,started chemotherapy there at the time of admission her haemoglobin is 4,platelet 10,000,peripheral smear shows blast presnt CSF NEGATIVE BONE MARROW NOT DONE induction chemotherapy started prednisolone oral inj.vincristine i.v 4 doses inj, daunorubicin 3 doses inj.L. asparaginase 8 doses IT ,methotrexate 3 times BONE MARRO DONE 3? BLAST SHOWS phase b inj.cyclophosphamide iv 2 time inj,cytarabine s/c [ arac] 4 days * 4 doses tab .6 mp 60 days IT METHOTREXATE 3 times tab.biotraxate RE INDUCTION PHASE tab.dexamethasone orally inj.vincristine iv 4 doses inj. dnr 4 doses inj.L .asparanginase 4 dose inj.cyclophosphamide 1 dose inj.cytarabine 2 dose it.methotrexate 2 doses BONE MARROW DONE SHOWS 3% BLASTS AND 5%LYMPHS CSF NEGATIVE given tab.6pm for one month review 20/8/2012 please given valuable comments how is the condition and what to do next?

Toni95

Non of this has helped me with my research :/ my sister has leukemia and none of the stuff above is even close!!

jasperkumar

i had ALL WEN I WAS 10. I was treated for a year and i was good for 10 years but i was diagnosed for ALL wen I WAS 20 . I was treated and i am okay now. is this possible?

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