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Diagnosing Acute Lymphoblastic Leukemia


Acute lymphoblastic leukemia (ALL) often grows rapidly, and quickly accomplished examinations with treatment starting after 1-2 days may be significant to save a patient with a large tumor mass.

For the choice of treatment, it is critical to have a comprehensive morphological, immunological, and cytogenetic characterization of the tumor cells.

ALL is separated into 3 subgroups (L1-L3). The grouping is based on the morphological examination after the FAB classification of blood and bone marrow smears and is supported by immunophenotyping, cytogenetic, and molecular genetic examinations as well as combinations of these techniques. WHO staging is increasingly applied also in Norway. 

ALL and lymphoblastic lymphoma have many similarities. Both diseases originate from rapid proliferating cells with blast morphology. Conditions with more than 25% lymphoblasts in bone marrow are considered acute lymphoblastic leukemia. If the bone marrow criteria is met, the condition is leukemia even with mediastinal tumors or other lymph node tumor.

Burkitt's lymphoma/leukemia (L3) originates from more mature B lymphocytes and requires special treatment. The treatment is determined by the type of tumor cells and not whether the disease manifests itself as leukemia or lymphoma. 


  • Suspicion of acute lymphoblastic leukemia


  • Confirm the diagnosis 
  • Identify risk group for disease progression
  • Cure the disease









Norsk selskap for hemtaologi. Handlingsprogram for diagnostikk og behandling av akutt lymfoblastisk leukemi/lymfoblastisk lymfom og burkitt lymfom leukemi hos voksne [Online]. Mars 2006 [hentet 15. april 2007]; tilgjengelig fra: URL:

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