Acute Lymphoblastic Leukaemia
Also written as ALL.
Factors associated with a favourable outcome of acute lymphoblastic leukaemia include one of the following:
What our notes say
- Factors associated with a favourable outcome of acute lymphoblastic leukaemia include one of the following: (Paediatrics end of fourth year main exam: 1 July 2019, Paper One, 99 of 100 MCQs)
- | Lymphadenopathy / organomegaly | Swollen neck, axillae, groin nodes; abdominal fullness, early satiety, early fullness after meals | Extramedullary disease – common in acute lymphoblastic leukaemia (ALL) and chronic lymphocytic leukaemia (CLL). | (Leukaemias)
- | Acute lymphoblastic leukaemia (ALL) | Young age, bone pain, lymphadenopathy, high lymphoblasts | Predominant lymphoblasts on smear; TdT⁺ on immunophenotyping | (Leukaemias)
- Outline the immunophenotypic markers used to differentiate acute lymphoblastic leukaemia (ALL) from acute myeloid leukaemia (AML), explaining the significance of each marker. (General & Systemic Pathology Exam: MBChB Year 3 Questions)
- Acute lymphoblastic leukaemia — requiring L-asparaginase based protocol (Haematopathology MCQs: Blood Disorders & Anemia Explained)
- Acute lymphoblastic leukaemia, chronic myeloid leukaemia, Kaposi sarcoma and malignant ovarian teratomas account for about 50% of all cancer cases globally (Oncopathology MCQs: Test Your Knowledge on Cancer Pathology)
Practice questions on Acute Lymphoblastic Leukaemia
A 35-year-old patient is diagnosed with lymphoma. Biopsy reveals TdT-positive cells. The presentation overlaps significantly with acute lymphoblastic leukaemia. What is the diagnosis?
- Burkitt lymphoma
- Mantle cell lymphoma
- Lymphoblastic lymphoma
- Peripheral T-cell lymphoma
Answer: C. TdT (terminal deoxynucleotidyl transferase) positivity is the hallmark of lymphoblastic lymphoma — it is negative in ALL other NHL types. Treated with ALL protocols.
The hallmark laboratory finding in acute lymphoblastic leukaemia (ALL) is
- Auer rods in blasts
- Lymphoblasts positive for TdT (terminal deoxynucleotidyl transferase)
- BCR-ABL in all cases
- Basophilia
Answer: B. TdT positivity marks immature lymphoid cells; it distinguishes ALL blasts from mature lymphocytes and myeloid blasts.