急性淋巴细胞白血病（Acute lymphoblastic leukemia）.docVIP

急性淋巴细胞白血病（Acute lymphoblastic leukemia） According to the cell size (FAB, our standard) in acute lymphoblastic leukemia 1. L1 cells were mainly small cells, and large cells were less than 0.25 (25%). L2 was mainly composed of large cells, 0.25 (25%). L3 large cells mainly, more cytoplasm, dark blue, long and short bubbles are honeycombed, called BurKitt type. According to the cell phenotype (WHO): the precursor B--ALL cell morphology such as L1 or L2, immune phenotype was B: CD19, CD22, CD79a, CD10 positive, TdT^+. Accounting for 80%~~85% in ALL. The precursor of T-ALL: cell morphology such as L1 or L2, immune phenotype was T: CD3, CD7, CD4, CD8 positive, TDT can also be positive, accounted for ALL 15%~~20% WHO L3 (BurKitt) in mature B cell tumor Edit the clinical presentation of this paragraph acute lymphoblastic leukemia Although the clinical manifestations of different types of ALL are different, they are basically the same. The main points are as follows: 1. Except for the onset of T-ALL, the general symptoms are relatively slow. Early manifestations of fatigue, weakness or irritability, loss of appetite, and occasional vomiting. Symptoms of viral upper respiratory tract infection, or rash, followed by weakness. Bone and joint pain are also common symptoms. 2, anemia occurs early was pale, with skin and oral mucosa is obvious, with the aggravation of anemia may occur after shortness of breath, weakness and other symptoms. Because of the rapid onset of T-ALL, anemia is not serious at the time of diagnosis. 3, fever, more than half of fever, fever type indefinite. The main cause of fever is secondary infection. 4, about half of the patients had bleeding epistaxis, gingival bleeding and skin purpura or petechia, ecchymosis, occasional intracranial hemorrhage. In addition to the mass and quantity of platelets, the reasons for bleeding can also be caused by the invasive damage of leukemic cells to the blood vessel wall and the increase of permeability. T-ALL occasiona