Acute Lymphocytic Leukaemia

A disease of the young – unless a “transformed” leukaemia Acute Lymphocytic Leukaemia

Symptoms: Bruising – why ? Bleeding – why ? Sudden acute infection – why ? Joint pains – why ? Any & all symptoms are of an acute onset Acute Lymphocytic Leukaemia

All symptoms result from a reduction in effective haemopoesis Acute Lymphocytic Leukaemia

In ALL there is a proliferation of a clone of lymphoid cells Which stop maturing at the blast stage So there is no effective lymphopoesis So lymphopoesis is accelerated And the marrow fills with leukaemic lymphoid cells At the expense of “normal” cells Acute Lymphocytic Leukaemia

How is this different from CLL & CML ? These cells proliferate RAPIDLY !!!! Acute Lymphocytic Leukaemia

The symptoms may be indicative of a range of conditions. The blood count is the give-away Hb Normal – ish On the low side Plts LOW ! < what ? Wbc Total count normal (usually) Blast cells seen Acute Lymphocytic Leukaemia

. And bone marrow aspiration as a confirmation What would you expect to see ? Acute Lymphocytic Leukaemia

An aside… The causes of ALL are largely unknown but…… It is prevalent in those with Down’s syndrome & other chromosomal conditions It is frequent in the identical twins of those who have it -which is problem !! Acute Lymphocytic Leukaemia

Treatment: The aim is to destroy the leukaemic cells And restore bone marrow function. Acute Lymphocytic Leukaemia

Treatment: Chemotherapy Is the main form of treatment Intravenously & into the CSF – (why) ? Acute Lymphocytic Leukaemia

Treatment: Radiotherapy As a backup to the chemotherapy Round the head & the testes – why ? (We’re not just being rude here !!) Acute Lymphocytic Leukaemia

Treatment: Following successful treatment Leukaemia has now gone. Chances are bone marrow function has too – why ? Bone marrow transplant Acute Lymphocytic Leukaemia

Treatment: Monitoring It’s a disease of the young And can relapse Acute Lymphocytic Leukaemia

Treatment: Relapse Three main sites of relapse: Bone marrow CSF Testes Acute Lymphocytic Leukaemia

Treatment: Relapse Treated with Different combinations of chemotherapy. Acute Lymphocytic Leukaemia

Prognosis: As treatment improves, cure rates are increasing. (This statement is deliberately vague) Acute Lymphocytic Leukaemia