clinical features

Last reviewed 01/2018

Most patients present with an acute illness of several days or less frequently, with tiredness or non-specific aches over several weeks or months.

Clinical features can be grouped into:

• consequences of bone marrow failure - anaemia, bleeding, vulnerability to infection
• consequences of accumulation of leukaemic cells

The patient with acute lymphoblastic leukaemia is usually a child, whereas the patient with acute myeloid leukaemia is rarely a child.

Although the marrow is usually extensively replaced by leukaemic cells, bone-related symptoms are uncommon. Rarely there may be bone tenderness in childhood ALL.

A common presentation of childhood ALL is with joint and muscle pain. ALL does not infiltrate extra-medullary tissues - lymph nodes, spleen, liver, meninges - as much as AML.

T cell ALL with mediastinal mass may present with stridor and wheezing, pericardial effusions, and superior vena cava syndrome (1).

CNS and gastrointestinal involvement may be increased in patients with mature B cell ALL. Chin numbness is also indicative of mature B cell ALL (2).

Reference:

• (1) Faderl S et al. Adult acute lymphoblastic leukemia: concepts and strategies. Cancer. 2010;116(5):1165-76.  
• (2) Jabbour EJ et al. Adult acute myeloid leukemia. Mayo Clin Proc. 2006;81(2):247-60.