ISSN 2398-2969      

Acute lymphoblastic leukemia (ALL)

icanis

Synonym(s): ALL


Introduction

  • See also leukemia Leukemia.
  • Definition: malignant neoplasm of unknown etiology consisting of immature, poorly differentiated lymphoblasts originating primarily in the bone marrow, with possible secondary infiltration of lymphatic organs. Neoplastic cells may or may not be circulating in the peripheral blood and can occasionally originate in the spleen.
  • Signs: non-specific but often severe:
    • Weakness.
    • Anorexia
    • Vomiting.
    • Diarrhea.
    • Pyrexia.
  • Clinial findings:
    • 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/ immunohistochemical staining (including flow cytometry) or PCR for antigen receptor rearrangement (PARR), and from lymphosarcoma by much milder lymphadenopathy, large numbers of circulating lymphoblasts, more severe myelosuppression, positive staining to CD34 (surface glycoprotein expressed on immature hematopoietic progenitor cells but not on more mature/ differentiated cells) upon flow cytometry.
  • Treatment: supportive and cytotoxic agents may be tried.
  • Prognosis: poor due to severe bone marrow infiltration and pancytopenia.
Print off the owner factsheet on Canine leukaemia to give to your client.

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 → myelophthisis 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.
  • Bennett A L, Williams L E, Ferguson M W, Hauck M L, Suter S E, Lanier C B, Hess P R (2017) Canine acute leukemia: 50 cases (1989-2014). Vet Comp Oncol 15(3), 1101-1114 PubMed
  • Tasca S, Carli E, Caldin M, Menegazzo L, Furlanello T, Solano Gallego L (2009) Hematologic abnormalities and flow cytometric immunophenotyping results in dogs with hematopoietic neoplasia: 210 cases (2002–2006). Vet Clin Pathol 38(1), 2-12 PubMed.
  • 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.
  • Mischke R, Freund M, Leinemann-Fink T, Eisenberger B, Casper J, Nolte I (1998) Changes in hemostasis of dogs with acute lymphoblastic leukemia]. Ber Munch Tierarztl Wochenschr 111(2), 53-59 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.

Other Sources of Information

  • Vail D M, Pinkerton M, Young K M (2020) Cancer chemotherapy. In: Small Animal Clinical Oncology. 6th edn. Eds Withrow & MacEwen. Elsevier Saunders, St. Louis. pp 712-715.
  • Presley R H, Mackin A,Vernau A (2006) Lymphoid Leukemia in Dogs. Compendium Dec 2006 831-849. 

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