The presenting symptoms and signs of ALL are quite variable. Most cases have an acute onset, while in others the initial signs and symptoms appear insidiously and persist for months. The presenting features generally reflect the degree of bone marrow failure and extent of extramedullary spread. A definitive diagnosis of ALL rests with examination of the bone marrow, which is usually replaced by leukemic lymphoblasts. The identification of reliable prognostic factors in ALL and its recognition as a heterogeneous disease have led to the use of risk-directed therapy.
Treatment is the single most important prognostic factor.
Indeed, many other variables have emerged as useful prognostic indicators, only to disappear as treatment has improved. For referrals and general information, please contact us.