Acute Leukemia


When there is presence of more than 20% of blast cells in the peripheral blood or the bone marrow at the time of presentation. Can be categorized into Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL).

Signs & Symptoms

Lethargy, pallor, fever, infections, spontaneous bruises, lymadenopathy, moderate hepatosplenomegaly and meningeal syndromes.

Risk Factors

AML occurs in all age groups. ALL is most common in children. B type ALL has equal sex incidence while T-ALL has a male predominance.


AML inv(16) and t(8;21); t(15;17). ALL t(12;21) (p13:q22).

Peripheral blood characteristics

Normochromic, normocytic anemia with thrombocytopenia. There’s variable number of blast cells.

BM characteristics

Hypercellular with more than 20% leukemic blast cells.

Important investigations & related results

AML MPO positive with Auer rods, Sudan black and PAS positive. ALL negative MPO and Sudan Black. Positive PAS with coarse block positivity.

Treatment & management



Induction (e.g. vincristine, asparginase, dexamethasone ± daunorubicin)

Consolidation (daunorubicin, cytosine arabinoside, vincristine, etoposide, thioguanine or mercaptopurine, cyclophosphoamide)

Cranial prophylaxis

Maintenance therapy (e.g. mercaptopurine, methotrexate, vincristine, dexamethasone)

Late intensification

Maintenance therapy

Induction (daunorubicin, cytosine arabinoside, etoposide)

Consolidation (daunorubicin, cytosine arabinoside, etoposide)

Consolidation (m-AMSA, etoposide, cytosine arabinoside)

Possible stem cell transplantation / further consolidation (mitoxantrone, idarubicin, high dose cytosine arabinoside)

Acute lymphoblastic leukemia x 400

Acute myeloid leukemia x 400

Bone marrow aspirate with positive myeloperoxidase stain in AML x 400

View our Upcoming Products

To facilitate the learning of our students we have developed a number of products that are due for release soon. These include a Practical Manual for Medical Undergraduates and two boardgames.