T-cell acute lymphoblastic leukemia | |
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T-lymphoblastic cells of acute leukemia in the bone marrow. In some cases, the cytoplasm is concentrated at one pole of the cell, forming "hand mirror cells". | |
Specialty | Haematology, oncology |
Symptoms | Recurrent infections, unusual or common bleeding and bruising, extreme tiredness, unexplained fever, unexplained weight gain, swollen lymph nodes |
Usual onset | Most prevalent in the adult population with incidences[spelling?] diminishing with age. Amongst pediatric population, median onset of age 9. Marked male predominance [1] |
Causes | Currently unknown |
Diagnostic method | Blood test, bone marrow aspiration,[2] biopsy, CT, MRI, lumbar puncture,[2] genetic testing |
Treatment | Long-term chemotherapy,[3] CNS radiation therapy,[1] stem cell transplantation [4] |
Prognosis | 5-Year Event Free Survival: 70%, Overall Survival: 80% [1] |
Frequency | 7% at ages 1-10, 14% at ages 10-15, and 29% at ages 15-18 [5] |
T-cell acute lymphoblastic leukemia (T-ALL) is a type of acute lymphoblastic leukemia characterized by an aggressive malignant neoplasm of the bone marrow.[6] Acute lymphoblastic leukemia (ALL) is a condition wherein immature white blood cells accumulate in the bone marrow, crowding out normal white blood cells[7] and also accumulate in the liver, spleen, and lymph nodes.[8]
The two most common cells involved in ALL are B-lymphocytes and T-lymphocytes. B-lymphocytes protect the body against viruses and bacteria through antibody production, whereas T-lymphocytes destroy bacteria or cells infected with viruses.[9] Approximately 20% of ALL patients suffer from T-ALL, which is more prevalent in the adult population compared to children, with incidence rate diminishing with age.[6][10]
Among T-ALL cases in the pediatric population, the median onset is age 9, and the disease is particularly prominent among adolescents.[6] The disease stems from cytogenic and molecular abnormalities, resulting in the disruption of developmental pathways controlling thymocyte development, tumour suppressor development, and alterations in control of cell growth and proliferation.[1]
Distinct from adult T-cell leukemia, in which T-cell lymphotropic virus Type I causes malignant maturation of T-cells, T-ALL is a precursor for lymphoid neoplasm.[6] Its clinical presentation most commonly includes infiltration of the central nervous system (CNS) and often is associated with a mediastinal mass originating from the thymus, along with extramedullary involvement of multiple organs, including the lymph nodes, as a result of hyperleukocytosis.
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