Chapter 26 Clinical Manifestations and Treatment of Acute Lymphoblastic Leukemia in Children
Table 26-1 Clinical Presentation of Acute Lymphoblastic Leukemia
| Symptoms and Signs | Etiology | Management |
|---|---|---|
| Fever | Disease or infection | Always conduct fever workup and provide broad antimicrobial coverage until infectious etiology is ruled out |
| Fatigue, pallor | Anemia (ALL infiltrating BM) | RBC transfusion (slow if anemia is severe; avoid in hyperleukocytosis) |
| Petechiae, bruising, bleeding | Thrombocytopenia (ALL infiltrating BM) | Transfuse with platelets |
| Pain | Leukemia infiltrating bones or joints or expanding BM cavity | Establish diagnosis and start chemotherapy |
| Respiratory distress, superior vena cava syndrome | Mediastinal mass | Avoid sedation in the presence of tracheal compression; establish diagnosis as soon as possible and start chemotherapy |
ALL, Acute lymphoblastic leukemia; BM, bone marrow; RBC, red blood cell.
