Canis ISSN: 2398-2942

Acute lymphoblastic leukemia

Synonym(s): ALL

Contributor(s): Laura Garrett

Introduction

  • See also leukemia Leukemia.
  • Cause: progressive, malignant infiltration of bone marrow and lymphatic organs by immature, poorly differentiated lymphoblasts of unknown etiology.
  • Signs: non-specific but often severe:
    • Weakness.
    • Vomiting.
    • Diarrhea.
    • Pyrexia.
    • Profound cytopenias: neutropenia, thromboctopenia, anemia.
    • Leukocytosis with massive numbers of lymphoblasts.
    • Infiltration of blast cells into spleen, liver, lymph nodes, other sites.
  • Diagnosis: blast cells in bone marrow, usually with similar cells in peripheral circulation; differentiate from other leukemias by cytochemical staining, and from lymphosarcoma by much milder lymphadenopathy, large numbers of circulating lymphoblasts and more severe myelosuppression.
  • Treatment: supportive and cytotoxic agents may be tried.
  • Prognosis: poor due to severe bone marrow infiltration and pancytopenia.

Pathogenesis

Etiology

  • Unknown; ? effect of oncogenic retroviruses, ionizing radiation, chemical exposure.

Pathophysiology

  • Neoplastic transformation → proliferation of early lymphoid cells → arrest of normal cell lineage differentiation → myelophthesis in bone marrow → profound cytopenias.
  • Lymphoblasts present in peripheral circulation → infiltration of spleen and liver → organomegaly → possible infiltration of lymph nodes → lymphadenopathy; may also see infiltration of nervous system and gastrointestinal tract.
  • Thrombocytopenia → petechiae, ecchymoses.

Timecourse

  • Weeks.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Adams J, Mellanby R J, Villiers E et al (2004) Acute b cell lymphoblastic leukaemia in a 12-week greyhound. JSAP 45, 553-557 PubMed.
  • Fournel-Flery C, Ponce F, Felman P et al (2002) Canine t-cell lymphomas: A morphological, immunological, and clinical study of 46 new cases. Vet Pathol 39, 92-109 PubMed.
  • Weiss D J (2001) Flow cytometric and immunophenotypic evaluation of acute lymphocytic leukemia in dog bone marrow. J Vet Intern Med 15, 598-594 PubMed.
  • Vernau K M, Terio K A, LeCouteur R A et al (2000) Acute b-cell lymphoblastic leukemia with meningeal metastasis causing primary neurologic dysfunction in a dogJ Vet Intern Med 14, 110-115 PubMed.
  • Ruslander D A, Gebhard D H, Tompkins M B et al (1997) Immunophenotypic characterization of canine lymphoproliferative disorders. In Vivo 11, 169-172 PubMed.


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