ALL

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MCC leukemia In children age 2-10

Risk factors

  • Down Syndrome
  • Males > females

Presentation

  • Infections (50%)
  • Lymphadenopathy and splenomegaly from extramedullary spread (50%)
  • Varying degrees of anemia (pallor), thrombocytopenia (petechiae), leukopenia (infection - WBC can be or )
  • Bone pain

Complications

Recurrence in CNS and testes

Diagnosis

  • Lymphoblasts in the peripheral smear
  • Bone marrow biopsy: >25% lymphoblasts (definitive Dx)
  • Strongly PAS +
  • TdT+
  • T(12:21) good prognosis
  • T(9:22) bad prognosis

Treatment

  • Chemo
  • Add intrathecal chemo to prevent CNS relapse

Differential diagnosis

AML (peroxidase positive granules, Auer Rods)