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Pathology - Acute B-lymphoblastic leukemia
Definition: A hematological neoplasm consisting of malignant B-lymphoid blasts.
Epidemiology: Rare occurrence. • Predominantly a pediatric ailment (75% of cases occur in those under 6 years of age)
Aetiology • Predominantly unknown, although there is an indication of a hereditary component in certain instances. Pathogenesis: Mutations in a hematopoietic stem cell result in the clonal proliferation of immature B-lymphoid blasts. • Lymphoid blasts proliferate rapidly, overwhelming normal bone marrow, entering peripheral circulation, and infiltrating other organs.
Presentation: • Abrupt development of bone marrow failure characterized by severe anemia and thrombocytopenia. The leukocyte count may be diminished, normal, or elevated. Infiltration of other organs is prevalent, resulting in lymphadenopathy, hepatosplenomegaly, bone pain, headache, vomiting, and cranial nerve palsies.
Microscopy • By definition, more than 20% of cells in the peripheral blood or bone marrow are lymphoid blasts. Lymphoid blasts are medium to large cells characterized by a high nuclear-to-cytoplasmic ratio. The immunophenotype of B-lymphoid blasts often includes the expression of CD19, CD79a, CD10, Pax5, and TdT.
Prognosis: Contemporary treatment protocols exhibit remarkable success rates, with complete remission attained in over 95% of pediatric patients.
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