Scenario 1: Acute Lymphoblastic Leukemia (ALL)

An 11-year-old boy is brought to the clinic by his parents, who state that he has not been eating and is listless. The mother also notes that he has been easily bruising without trauma, as he says he is too tired to go out and play. He says his bones hurt sometimes. The mother states the child has had intermittent fevers that respond to acetaminophen.

Maternal history negative for pre, intra, or post-partum problems.

PMH: Negative. Easily reached developmental milestones.

PE: reveals a thin, very pale child with bruises on his arms and legs in no particular pattern.

LABS: CBC revealed Hemoglobin of 6.9/dl, hematocrit of 19%, and platelet count of 80,000/mm³. The CMP demonstrated a blood urea nitrogen (BUN) of 34m g/dl and creatinine of 2.9 mg/dl.

DIAGNOSIS: acute leukemia and renal failure and immediately refers the patient to the Emergency Room where a pediatric hematologist has been consulted and is waiting for the boy and his parents.

CONFIRMED DX: acute lymphoblastic leukemia (ALL) was made after extensive testing.

Question

1.     Explain what ALL is?