B-Cell Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma Clinical - Primarily a disease of childhood, 75% <6 yo - Increased risk in trisomy 21 - LBL has predominantly extramedullary disease with limited BM involvement (<25%) - Most common sites of LBL involvement are skin, soft tissue, bone, and LN - Presents with bone pain, cytopenias, LAD Risk stratification: - Traditionally based age, WBC count and response to chemotherapy; now often based on genetics Good Prognosis: - Children - ETV6-RUNX1 - very good prognosis - Hyperdiploidy Bad Prognosis: - Infants and older adults - Patients with higher WBC count, CNS involvement, MRD, etc - t(9;22)- worst prognosis - KMT2A - Hypodiploidy - iAMP21 - BCR-ABL-like Intermediate/unknown: - t(1;19) - t(5;14) Dr. Laura Brown @lauraebrown #BCell #ALL #LBL #Acute #Lymphoblastic #Leukemia #Lymphoma #hemepath #pathology #prognosis
