B cell acute lymphoblastic leukemia/lymphoma

B cell acute lymphoblastic leukemia/lymphoma
Updated: 08/28/2024
© Jun Wang, MD, PhD

General features
  • Most common pediatric leukemia
  • Lymphoma is defined as localized disease with <20% lymphoblasts in marrow and peripheral blood
Clinical presentations
  • Abrupt stormy onset
  • Pancytopenia due to bone marrow depression
  • Bone symptoms: pain, tenderness
  • Lymphadenopathy
  • Internal organ involvement: hepatosplenomegaly, testicular involvement, central nervous system manifestations
Key Laboratory findings
Key morphological features of lymphoblast
  • Larger than normal lymphocytes
  • Scant cytoplasm
  • NO granules
  • NO Auer rods
Markers
  • CD34, CD99, TdT, bcl-2, CD19, CD79a, PAX5
Genetic abnormalities
  • Various
  • Hyperdipoidy (>50 chromosomes): Excellent prognosis with antimetabolite-based therapy
  • Hypodiploidy (< 44 chromosomes): Poor prognosis, high frequency of RAS pathway mutation
  • t(12;21)(p13;q22): ETV6-RUNX1
  • t(9;22)(q34;q11.2): bcl-abl1, prognosis improved with imatinib addition to intensive chemo
  •  t(4;11)(q21;q23): MLL-AFF (AF4)
  • Translocation involving cytokine receptor-like factor 2 (CRLF2): poor prognosis
  • JAK2 mutation (R683G: NOT as V617F seen in MPN): poor prognosis


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Comments

  1. admin 1October 12, 2018 at 3:21 AM


    why not proper treatment for acute lymphoblastic leukemia
    acute lymphoblastic leukemia

    ReplyDelete
    Replies
    1. Jun Wang, MD, PhDOctober 12, 2018 at 10:13 AM

      This blog is designed to help medical students learning basic pathology in their preclinical years, and for their preparation of COMLEX 1 and/or USMLE step 1. Treatment is barely needed, unless it is associated with specific pathogenesis, such as all-tran-retinoic acid for APL.

      Delete

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