Clinical Presentation and Prognostic Factors

Whilst there is a classic triad of symptoms (pallor, fever and easy bruising) are present in a majority of patients with ALL, a significant minority have a more varied presentation. Bone pain and the signs and symptoms of mediastinal and central nervous system involvement are of particular relevance. Time to presentation for medical attention is related to presenting symptoms. In this chapter, the clinical and laboratory features of ALL at presentation are discussed, as are the essentialdiagnostic investigations. Finally, clinical and laboratory prognostic variables and their interactions are reviewed.