hematology and oncology
Acute Lymphoblastic Leukemia (ALL)
Symptoms and Signs of ALL
Symptoms and signs of acute lymphoblastic leukemia may be present for only days to weeks before diagnosis. The most common presenting symptoms are due to disrupted hematopoiesis with ensuing Anemia Thrombocytopenia Granulocytopenia Anemiacan manifest with fatigue, weakness, pallor, malaise, dyspnea on exertion, tachycardia, and exertional chest pain. Thrombocytopeniacan cause mucosal bleeding, easy bruising, petechiae/purpura, epistaxis, bleeding gums, and heavy menstrual bleeding. Hematuria and gastrointestinal bleeding are uncommon. Patients can present with spontaneous hemorrhage, including intracranial or intra-abdominal hematomas. Granulocytopenia or neutropeniacan lead to a high risk of infections, including those of bacterial, fungal, and viral etiologies. Patients may present with fevers and a severe and/or recurrent infection. Organ infiltration by leukemic cellsresults in enlargement of the liver, spleen, and lymph nodes. Bone marrow and periosteal infiltration may cause bone and joint pain, especially in children with ALL. CNS penetration and meningeal infiltration are common and can result in cranial nerve palsies, headache, visual or auditory symptoms, altered mental status, and transient ischemic attack/stroke. 