Acute Lymphoblastic Leukemias

ALL is the most common malignancy in children and accounts for approximately 80 percent of childhood leukemia.12'13 ALL seems to be a heterogeneous group of disorders with subgroups that have distinct clinical and prognostic features. It derives from the clonal proliferation of lymphoid progenitors in the bone marrow. The consequence of bone marrow infiltration is various cytopenias in the peripheral blood and is associated with the appearance of peripheral blast cells. In some instances, leukemic cells are not seen in the peripheral blood. Thus, examination of the bone marrow is certainly necessary to confirm the diagnosis. Since the central nervous system (CNS) is infiltrated at diagnosis in 5 percent of patients, examination of the cerebrospinal fluid (CSF) by cytocentrifuge is also necessary.

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