Monday, October 5, 2009

Leukemia

Acute Limphoblastic Leukemia (ALL).







Acute Limphoblastic Leukemi (ALL).


Definition
Acute Limphoblastic Leukemia (ALL) is a clonal malignancy from precursor lifoid cells. About more than 80% cases, the dangerous cells come from limphocite B, and about 20% or less come from limphocite T. this type of leukemia attacks more in children. and about 20% this cancer cases attack in adult.


Etiology
the ALL cases is idiopatic in adult. the Genetic factor is more related in children's ALL cases. Environment also support occurance this disease. there are Ionic radiation, Chemotherapy drugs, , Epstein Barr Infection, high levels benzene exposure, smoke.


Clinical Presentation
there are many kind of clinical presentations.generally, there are the clinical symptoms related to the bone marrow failure. the Accumulation from Limphoblast cells malignant in bone marrow, cause the lack of blood normal cells in perifer. So, The clinical symptoms may related to anemia, infection, and Bleeding. but, the massive bleeding is rarely found.


the symptoms of ALL may found in clinical pictures can include :
  1. Anemia, Fatigue, letargy, chest pain, dizziness, shortness
  2. Anoreksia
  3. pain in bone and joint ( because the infiltrating leukemia cells in bone marrow)
  4. hipermetabolism symptoms ( fever and much sweting)
  5. petechiiae, atraumattic ecchymosis, hematuria, GIT's bleeding
  6. hepatomegaly
  7. Splenomegaly
  8. Limphadenophaty
  9. Mass in mediastinum ( often in cell T ALL )
  10. etc


Differential Diagnosis
-Anemia Aplastic
-Limphocytosis , Limphadenophaty, and Hepatosplenomegaly which relate to virus infection and limphoma


Laboratory pictures
generally, there are found Anemia and Trombocytopenia. about one-third patients have the trombotic count less than 25.000/mm3 .


Diagnosis Approach
  • Anamnesis
  • physical examination
  • Laboratory examination
  • thorax photo or Computed tomography
  • Lumbal Pungsi
  • Aspiration and bone marrow biopsy


Source: Buku Ajar Ilmu Penyakit Dalam Jilid II Edisi IV page 728-30 ( Text Book)




another review about Mesothelioma ( Pleural Cancer )

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