Clinical features of leukaemic cell accumulation

These include:

• bone and joint pain:
  • particularly in children with ALL
    
    
• hyperleukocytosis:
  • due to high counts ( >100 x 10^9 / l) of circulating blasts
  • symptoms include headache, convulsion, fits, focal neurology and coma
    
    
• tissue deposits of leukaemic cells:
  • for example, causing gum hypertrophy, stomatitis
  • more common in the myelomonocytic and monocytic varieties of AML
    
    
• CNS involvement:
  • especially in ALL
  • occurs in 25 to 50% children and 10 to 20% of adults with acute leukaemia
    
    
• acute haemostatic failure:
  • associated with the promyelocytic (M3) variant of AML in which the cells release cytoplasmic granular content, thus activating coagulation and fibrinolytic systems
    
    
• lymphadenopathy and hepatosplenomegaly:
  • more common in ALL than in AML