The French-American-British (FAB) classification, while historically significant, is no longer the primary system used for classifying acute lymphoblastic leukemia (ALL). Instead, the World Health Organization (WHO) classification is now preferred, considering cytogenetics and other factors in addition to morpholog

1. Guided by-Dr.Firoz sir
Dr.Chandni ma'am
Dr.Abhilasha ma'am
[
[ACUTELYMPHOBLASTICLEUKEMIA]
ACUTELYMPHOBLASTICLEUKEMIA]
FAB&WHOCLASSIFICATION
FAB&WHOCLASSIFICATION
Presented by- Rohan (96)
R.Lekhya(97)
Rugved(98)
Sakshi(100)

2. What is leukemia?
What is leukemia?
A Cancer found in the blood and bone marrow,caused by too many
white blood cells in the body.The white blood cells don’t let the
body fight disease and prevent the body from making red blood
cells and platelets.

3. Types of leukemia
Acute
lymphoblastic
leukemia
Acute
myelogenous
leukemia
Chronic
lymphoblastic
leukemia
Chronic
myelogenous
leukemia
Types of leukemia...
Types of leukemia...
Based on Disease Progression (Speed & Severity)

4. Definition
Malignant disorder of lymphoid progenitor cells (B- or T-
cell lineage).
Characterized by accumulation of immature
lymphoblasts in bone marrow, blood, and extramedullary
sites
Introduction To ALL
Introduction To ALL

5. Epidemiology
Most common childhood cancer (~30% of pediatric
malignancies).
Peak incidence: 2–5 years of age (B-ALL more common in
children; T-ALL in adolescents).
Adult ALL: Less common (20% of adult leukemias), with
poorer prognosis.

7. Classification
FAB Classification WHO Classification
ALL is classified using two major classification systems:

8. FAB Classification
ALL-L1 ALL-L2 ALL-L3
Cell size-Small
Cytoplasm-scanty
Nucleoli-Small
Cell size-Large
Cytoplasm-Variable
Nucleoli-one or more
Cell size-Large
Cytoplasm-moderate abundant
Nucleoli-one or more prominent

9. WHO Classification
B-ALL[85%] T-ALL[15%]
Origin: B-cell precursors (bone marrow)
Common in: Children (~85% of ALL cases)
Markers: CD10, CD19, CD22, CD79a
Treatment-Chemotherapy (Vincristine, L-
Asparaginase)
Origin: T-cell precursors (thymus)
Common in: Adolescents (~15% of ALL
cases)
Markers: CD2, CD3, CD4, CD5, CD7,
CD8
Treatment-Intensive chemotherapy

10. Good Prognosis Bad prognosis
Hyperdiploidy Hypodiploidy
Trisomy of 4,7,10
Pheladelphia
chromosome
t(12;21) MLL 1 gene
ALL
Genetics

11. Clinical Features
Due to bone marrow failure-
Anemia
Bleeding manifestations-petechiae,bleeding from gums
Symptoms-Fatigue,Bones or joint pain,Fever,Weight
loss,Abnormal masses,Purpura

12. Physical Finding's-
Splenomegaly
lymphadenopathy
hepatomegaly
sternal tenderness
Investigations -
CBC-Anemia.Thrombocytopenia,leucopenia
Peripheral blood smear-Blast cells are seen

13. Laboratory findings
Blood picture
a)anemia
b)thrombocytopenia
c)WBC’s-Leukocytosis
Bone marrow examination -
a)Cellularity-Hypercellular
b)Erythropoiesis-Reduced
c)megakaryocytes-Reduced
Cytogenetics-
Hyperdiploidy
hypodiploidy
Trisomy-4,7,10
t(9;12)
t(9;22)
t(4;11)

14. Treatment
1.Treatment of Anemia and hemorrhage
a)Blood transfusions
b)Platelet transfusion
2.Chemotherapy
a)Vincristine
b)prednisolone
c)Anthracyclines
d)L-Asparaginase

15. References-
Harsh mohan
Robbins and Cotran

16. Thank you!!