Haematology & Oncology

Acute Lymphoblastic Leukaemia (ALL)

A maturation arrest in the lymphoid lineage lets lymphoblasts proliferate and fill the marrow, causing rapid marrow failure plus a distinctive tendency to infiltrate the central nervous system and testes; it is the commonest childhood cancer.

Definition

Acute lymphoblastic leukaemia is a rapidly progressive malignancy of lymphoid precursors, classified as B-lineage or T-lineage by integrated morphology and immunophenotyping, with genetic findings guiding risk and treatment.

First principles

A lymphoid maturation arrest fills the marrow with lymphoblasts

ALL arises from an abnormal lymphoid precursor that accumulates as lymphoblasts and suppresses normal marrow production. Immunophenotyping separates B-lineage from T-lineage disease and identifies lesions such as BCR::ABL1 that change treatment.

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