Acute lymphoblastic leukemia (ALL)

Clonal proliferation and accumulation of blast cells from lymphoid series in blood, bone marrow and other organs

Disorder  originates in single B or T lymphocyte progenitor 

B cell type – 80%     T cell type – 20%
Common age group – 5 to 15 yrs
Etiology  - unknown 

Acute leukemias - clinical features

1. Bleeding
2. Fever/infection
3. Fatiguability and pallor
4. Hepatomegaly
5. Splenomegaly
6. Lymphadenopathy
7. CNS involvement
8. Testicular involvement in males

Acute leukemias - laboratory findings 

1. Blood examination - anemia, - thrombocytopenia, - variable leukocyte count, usually increased from 10,000 to 500,000/cmm - blood morphology: presence of blast cells 

2. Bone marrow morphology - presence of blast cells (>20%) - suppression of normal hematopoiesis
3. Cytochemical stains
4. Immunophenotyping
5. Cytogenetics

Immune phenotyping
Morphologic subtypes of acute lymphoblastic leukemias  (FAB classification)

Subtype           Morphology       Occurrence (%)
L1   Small round blasts              75
clumped chromatin
L2 Pleomorphic larger blasts     20
clefted nuclei, fine chromatin
L3 Large blasts, nucleoli,       5

vacuolated cytoplasm

Chromosomal/molecular abnormalities with prognostic significance in ALL

Better prognosis
- normal karyotype
- hyperdiploidy
Poor prognosis
- t (8; 14)
- t (4; 11)
Very poor prognosis
- t (9; 22); BCR/ABL (+)

 Treatment strategy in ALL

Remission induction therapy in ALL

1. Antineoplastic treatment
a.Drugs: L-asparaginase, Daunorubicin, Prednisolone, Vincristine
    b/Treatment duration: 4-8 weeks
c/ No of courses: 1- 2
2. CNS prophylaxis – Methotrexate (intrathecal)
3. Supportive care

4. Treatment of complications


Drugs – Etoposide, cytarabine, and Daunorubicn, Methotrexate(I.v.)

Stem Cell transplantation

Maintenance of remission

  • Prednisolone, Vincristine, Mercaptopurine and Methotrexate (oral)
  • May need to be continued for 2-3 years

Treatment results in ALL 

Complete remission  (CR) 80-85%
Leukemia-free survival (LFS)            30-40%

Complete remission (CR) 95-99%
Leukemia-free survival (LFS)            70-80%


  1. mbbs in Philippines
    Every year, almost 8000 foreign students take admission in Philippines Medical universities and out of which around 50% are Indian students. The standard of education in Philippines universities is well known around the world. Thousands of doctors from these medical universities are sent to various countries like USA and UK every year. There are around 2299 higher educational institutions and 40 medical colleges. The main benefits of pursuing MD degree from

    Top Medical Colleges in Philippines :


    Top Searched Topics on MBBS in Philippines

    study mbbs in philippines
    philippines medical colleges list
    best medical colleges in philippines for indian students
    philippines medical colleges
    best medical colleges in philippines
    mci approved medical colleges in philippines

    for more information contact us : +91 90329 55688

  2. UV GULLAS COLLEGE OF MEDICINE is one of Top Medical College in Philippines in Cebu city. International students have the oppertunity to study medicine in phillipines at affordable cost and world class University. The college has successful alumni who have achieved well in the fields of law, business, politics, academe, medicine, sports and other endeavors. At University of the Visayas, we prepare students for a global competition.

    Direct MBBS Admissions Open: 2020-21
    Mobile No: +91 90329 55688
    Apply Now:

  3. MBBS in Philippines Wisdom Overseas is authorized India's Exclusive Partner of Southwestern University PHINMA, the Philippines established its strong trust in the minds of all the Indian medical aspirants and their parents. Under the excellent leadership of the founder Director Mr. Thummala Ravikanth, Wisdom meritoriously won the hearts of thousands of future doctors and was praised as the “Top Medical Career Growth Specialists" among Overseas Medical Education Consultants in India.

    Why Southwestern University Philippines
    5 years of total Duration
    3D simulator technological teaching
    Experienced and Expert Doctors as faculty
    More than 40% of the US returned Doctors
    SWU training Hospital within the campus
    More than 6000 bedded capacity for Internship
    Final year (4th year of MD) compulsory Internship approved by MCI (No need to do an internship in India)
    Vital service centers and commercial spaces
    Own Hostel accommodations for local and foreign students
    Safe, Secure, and lavish environment for vibrant student experience
    All sports grounds including Cricket, Volleyball, and others available for students


Popular Posts