Tanda Dan gejala SEMUA meliputi berikut Penyanyi:

Demam
Jangka Waktu neutrofil menurun
Tanda dan gejala anemia, seperti pucat, kelelahan, pusing, jantung berdebar, murmur
aliran jantung, dan dyspnea dengan tenaga bahkan ringan
Perdarahan (misalnya, dari trombositopenia karena penggantian sumsum)
Disseminated intravascular coagulation (DIC) di diagnosis (sekitar 10% dari kasus)
limfadenopati teraba
Gejala yang terkait dengan massa mediastinum besar (misalnya, sesak napas), terutama
dengan T-sel SEMUA
nyeri tulang (parah dan sering atipikal)
Meninggalkan kuadran kepenuhan atas dan cepat kenyang karena splenomegali (Sekitar
10-20% kasus)
Gejala leukostasis (misalnya, gangguan pernapasan, perubahan status mental)
gagal ginjal pada pasien dengan beban tumor yang tinggi
Infeksi, termasuk pneumonia
Petechiae (terutama pada ekstremitas bawah) dan ekimosis
Signs relating to organ infiltration with leukemic cells and lymphadenopathy
Rashes from skin infiltration with leukemic cells

Diagnosis
Laboratory tests and other studies used in the workup for ALL include the following:

Complete blood count with differential

Coagulation studies
Peripheral blood smear
Chemistry profile, including lactic dehydrogenase, uric acid, liver function studies, and
BUN/creatinine
Appropriate cultures (in particular, blood cultures) in patients with fever or other signs of
infection
Chest x-ray
Computed tomography
Multiple-gated acquisition scanning
Electrocardiography
Bone marrow aspiration and biopsy (definitive for confirming leukemia)
Immunohistochemistry
Flow cytometry
Cytogenetics
Polymerase chain reaction
Gene expression profiling
Management
Treatment of ALL may include the following:

Induction chemotherapy (eg, standard 4- or 5-drug regimen, ALL-2, or hyper-CVAD)

Consolidation chemotherapy
Maintenance chemotherapy
Intrathecal chemotherapy for central nervous system (CNS) prophylaxis
Supportive care (eg, blood products, antibiotics, growth factors)

Pathophysiology
The malignant cells of acute lymphoblastic leukemia (ALL) are lymphoid precursor cells (ie,
lymphoblasts) that are arrested in an early stage of development. This arrest is caused by an
abnormal expression of genes, often as a result of chromosomal translocations. The lymphoblasts
replace the normal marrow elements, resulting in a marked decrease in the production of normal
blood cells. Consequently,anemia, thrombocytopenia, and neutropenia occur to varying degrees.
The lymphoblasts also proliferate in organs other than the marrow, particularly the liver, spleen,
and lymph nodes.

Etiology
Less is known about the etiology of acute lymphoblastic leukemia (ALL) in adults compared
with acute myelogenous leukemia (AML). Most adults with ALL have no identifiable risk
factors.

Although most leukemias occurring after exposure to radiation are AML rather than ALL, an
increased prevalence of ALL was noted in survivors of the Hiroshima atomic bomb but not in
those who survived the Nagasaki atomic bomb.

Rare patients have an antecedent hematologic disorder (AHD) such as myelodysplastic

syndrome (MDS) that evolves to ALL. However, most patients with MDS that evolves to acute
leukemia develop AML rather than ALL. Similarly, a small number of patients receiving
lenalidomide as maintenance therapy for multiple myeloma have developed secondary ALL. [1]
Increasingly, cases of ALL with abnormalities of chromosome band 11q23 following treatment
with topoisomerase II inhibitors for another malignancy have been described. However, most
patients who develop secondary acute leukemia after chemotherapy for another cancer develop
AML rather than ALL.

Epidemiology
Acute lymphoblastic leukemia (ALL) is the most common type of cancer and leukemia in
children in the United States. ALL accounts for 75% of pediatric leukemia cases. [2]

In adults, this disease is less common than acute myelogenous leukemia (AML). Sekitar 1000
kasus baru SEMUA terjadi pada orang dewasa setiap tahun. Namun, karena fakta bahwa ada
lebih dewasa daripada anak-anak, jumlah kasus terlihat pada orang dewasa sebanding dengan
yang terlihat pada anak-anak. SEMUA sedikit lebih umum pada laki-laki daripada perempuan.

Di Seluruh Dunia, Insiden tertinggi SEMUA Terjadi di Italia, Konsultasi Kesehatan, Hukum,
Swiss, dan Kosta Rika.