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Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in daily practice.
Klin Padiatr. 2009 Nov-Dec; 221(6):369-73.KP

Abstract

BACKGROUND

The aim of this study is to identify clinical "red flags" that may assist the general pediatrician in detecting patients with an acute lymphoblastic leukemia (ALL).

PATIENTS AND METHODS

Medical history and clinical findings of 189 children and adolescents, diagnosed with ALL between 1/1995 and 7/2004, were analyzed retrospectively.

RESULTS

Only 50% of patients presented with symptoms known in children with leukemia (fever, fatigue, paleness, hemorrhage); 5% were diagnosed accidentally in the absence of any clinical symptoms. The majority of patients had a medical history up to few weeks; in 11% of patients up to several months without impairing curability. 95% of the patients presented at diagnosis with enlargement of lymphnodes, liver and/or spleen. The characteristic laboratory constellation included mono-, respectively bi- or trilinear pathology of the blood count and with blasts in the blood smear.

CONCLUSION

The clinical diagnosis of ALL relies on physical examination and the blood count including microscopic examination. Therefore, the alertness of the treating paediatrician with regard to clinical findings and a pathologic blood count is more important than elaborate laboratory investigations. In uncertain cases, a close follow-up examination may help to unmask ALL, which will most likely be stratified in the low-risk-group.

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Authors+Show Affiliations

Bernbeck B
Klinikum Dortmund, Westfälisches Kinderzentrum, Dortmund, Germany. Benedikt.Bernbeck@klinikumdo.de
Wüller D
No affiliation info available
Janssen G
No affiliation info available
Wessalowski R
No affiliation info available
Göbel U
No affiliation info available
Schneider DT
No affiliation info available

MeSH

AdolescentAntineoplastic AgentsBlast CrisisBone MarrowChildChild, PreschoolCore Binding Factor Alpha 2 SubunitDelayed DiagnosisDisease-Free SurvivalFemaleGene Expression Regulation, LeukemicGermanyHemoglobinometryHepatomegalyHumansImmunophenotypingIncidental FindingsInfantLeukocyte CountLymph NodesLymphatic DiseasesMaleOncogene Proteins, FusionPediatricsPhysical ExaminationPlatelet CountPrecursor Cell Lymphoblastic Leukemia-LymphomaRetrospective StudiesSplenomegaly

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19890789

Citation

Bernbeck, B, et al. "Symptoms of Childhood Acute Lymphoblastic Leukemia: Red Flags to Recognize Leukemia in Daily Practice." Klinische Padiatrie, vol. 221, no. 6, 2009, pp. 369-73.
Bernbeck B, Wüller D, Janssen G, et al. Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in daily practice. Klin Padiatr. 2009;221(6):369-73.
Bernbeck, B., Wüller, D., Janssen, G., Wessalowski, R., Göbel, U., & Schneider, D. T. (2009). Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in daily practice. Klinische Padiatrie, 221(6), 369-73. https://doi.org/10.1055/s-0029-1239538
Bernbeck B, et al. Symptoms of Childhood Acute Lymphoblastic Leukemia: Red Flags to Recognize Leukemia in Daily Practice. Klin Padiatr. 2009 Nov-Dec;221(6):369-73. PubMed PMID: 19890789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptoms of childhood acute lymphoblastic leukemia: red flags to recognize leukemia in daily practice. AU - Bernbeck,B, AU - Wüller,D, AU - Janssen,G, AU - Wessalowski,R, AU - Göbel,U, AU - Schneider,D T, Y1 - 2009/11/04/ PY - 2009/11/6/entrez PY - 2009/11/6/pubmed PY - 2010/2/18/medline SP - 369 EP - 73 JF - Klinische Padiatrie JO - Klin Padiatr VL - 221 IS - 6 N2 - BACKGROUND: The aim of this study is to identify clinical "red flags" that may assist the general pediatrician in detecting patients with an acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: Medical history and clinical findings of 189 children and adolescents, diagnosed with ALL between 1/1995 and 7/2004, were analyzed retrospectively. RESULTS: Only 50% of patients presented with symptoms known in children with leukemia (fever, fatigue, paleness, hemorrhage); 5% were diagnosed accidentally in the absence of any clinical symptoms. The majority of patients had a medical history up to few weeks; in 11% of patients up to several months without impairing curability. 95% of the patients presented at diagnosis with enlargement of lymphnodes, liver and/or spleen. The characteristic laboratory constellation included mono-, respectively bi- or trilinear pathology of the blood count and with blasts in the blood smear. CONCLUSION: The clinical diagnosis of ALL relies on physical examination and the blood count including microscopic examination. Therefore, the alertness of the treating paediatrician with regard to clinical findings and a pathologic blood count is more important than elaborate laboratory investigations. In uncertain cases, a close follow-up examination may help to unmask ALL, which will most likely be stratified in the low-risk-group. SN - 1439-3824 UR - https://www.unboundmedicine.com/medline/citation/19890789/Symptoms_of_childhood_acute_lymphoblastic_leukemia:_red_flags_to_recognize_leukemia_in_daily_practice_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1239538 DB - PRIME DP - Unbound Medicine ER -