ISSN 2398-2950      

Acute lymphoblastic leukemia

ffelis

Synonym(s): ALL, Lymphoproliferative disease


Introduction

  • Cause: acute onset of progressive, malignant infiltration of bone marrow and lymphatic organs by immature, poorly differentiated lymphoblasts which are commonly present in peripheral blood. Most cases are FeLV positive and from the FeLV era.
  • Signs: non-specific but often severe, eg anorexia, weakness, vomiting, diarrhea, pyrexia and occasionally neurological signs.
  • Diagnosis: numerous lymphoblasts in bone marrow and similar cells in peripheral circulation. Immunostaining, flow cytometry and/or PARR (PCR for antigen receptor rearrangement) can help for definitive diagnosis.
  • Treatment: supportive and cytotoxic agents may be tried.
  • Prognosis: poor due to severe cytopenias.
Print off the owner factsheet on Feline leukaemia to give to your client.

Pathogenesis

Etiology

Pathophysiology

  • Normal hemopoietic cells are crowded out of bone marrow by neoplastic lymphoblasts which proliferate rapidly.
  • Results in neutropenia, thrombocytopenia and anemia.
  • Neoplastic lymphoblasts may also spill out into the peripheral blood → lymphocytosis.
  • FeLV Feline leukemia virus disease most common cause.
  • FIV infection Feline immunodeficiency virus disease may also predispose.
  • Neoplastic transformation of lymphoid precursor cells   →   proliferation of early lymphoid cells   →   crowds out bone marrow, competes for nutrients, release of inhibitory substances   →   reduced production of normal hemopoietic cells   →   profound cytopenias.
  • Neutropenia →  infections, sepsis.
  • Thrombocytopenia Thrombocytopenia   →   spontaneous bleeding, petechial hemorrhages, intestinal bleeding.
  • Non-regenerative anemia Anemia: overview  →  weakness, fatigue.
  • Neoplastic lymphoblasts often infiltration of lymphatic tissue →  splenomegaly, hepatomegaly   →   organ dysfunction; and sometimes lymphadenopathy which is mild compared with lymphadenopathy due to lymphoma.
  • Occasionally central nervous system (CNS) is infiltrated  →  neurological signs, eg seizures  Seizures.

Timecourse

  • Rapid - 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.
  • Cristo T G, Biezus G, Noronha L F, Gaspar T, Dal Pont T P, Withoeft J A, Furlan L V, Costa L S, Traverso S D, Casagrande R A (2019) Feline Leukaemia Virus Associated with Leukaemia in Cats in Santa Catarina, Brazil. J Comp Pathol 170,10-21 PubMed.  
  • Tomiyasu H, Doi A, Chambers J K, Goto-KoshinoY, Ohmi A, Ohno K, Tsujimoto H (2018) Clinical and clinicopathological characteristics of acute lymphoblastic leukaemia in six cats. J Small Anim Pract 259(12), 742-746 PubMed
  • Roccabianca P, Vernau W, Caniatti M et al (2006) Feline large granular lymphocyte (LGL) lymphoma with secondary leukemia: primary intestinal origin with predominance of a CD3/CD8(alpha)(alpha) phenotype. Vet Pathol 43 (1), 15-28 PubMed.
  • Louwerens M, London C A, Pedersen N C et al (2005) Feline lymphoma in the post-feline leukemia virus era. J Vet Intern Med 19 (3), 329-335 PubMed.
  • Stockham S L, Keeton K S, Szladovits B (2003) Clinical assessment of leukocytosis: distinguishing leukocytoses caused by inflammatory, glucocorticoid, physiologic, and leukemic disorders or conditions. Vet Clin North Am Small Anim Pract 33 (6), 1335-1357 PubMed.
  • Shelton G H, McKim K D, Cooley P L et al (1989) Feline leukemia virus and feline immunodeficiency virus infections in a cat with lymphoma. J Am Vet Med Assoc 194 (2), 249-252 PubMed.
  • Cotter S M (1983) Treatment of lymphoma and leukemia with cyclophosphamide, vincristine and prednisone: II Treatment of cats. J Am Anim Hosp Assoc 19 (2), 166-172 VetMedResource.

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 729-730.

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