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Because Burkitt leukemias are managed according to different treatment algorithms, it is important to specifically identify these cases prospectively by their L3 morphology, absence of Td T, and expression of surface immunoglobulin.
Patients with Burkitt leukemias will typically have one of the following three chromosomal translocations: Successful treatment of acute lymphoblastic leukemia (ALL) consists of the control of bone marrow and systemic disease and the treatment (or prevention) of sanctuary-site disease, particularly the central nervous system (CNS).[1,2] The cornerstone of this strategy includes systemically administered combination chemotherapy with CNS preventive therapy.
CNS prophylaxis is achieved with chemotherapy (intrathecal and/or high-dose systemic therapy) and, in some cases, cranial radiation therapy.
Among 36 live offspring of survivors, two congenital problems occurred. In adults, French-American-British (FAB) L1 morphology (more mature-appearing lymphoblasts) is present in fewer than 50% of patients, and L2 morphology (more immature and pleomorphic) predominates. L3 (Burkitt) acute lymphoblastic leukemia (ALL) is much less common than the other two FAB subtypes.
This last point is of utmost importance, as timely diagnosis of Ph1 ALL will significantly change the therapeutic approach.
Diagnostic confusion with AML, hairy cell leukemia, and malignant lymphoma is not uncommon.
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It is characterized by blasts with cytoplasmic vacuolizations and surface expression of immunoglobulin, and the bone marrow often has an appearance described as a “” owing to the presence of numerous apoptotic cells.