Michael Grunwald, MD, presents the case of a 32-year-old woman with AYA ALL, and Kelly Weaver, NP, DNP, discusses the role of cytogenetics in diagnosing patients with AYA ALL.
A 32-year-old female with a history of migraines and anxiety presented to the Emergency Department with a one-month history of fatigue and weakness and a two-day history of spontaneous bruising.
The patient had been undergoing an outpatient workup for anemia with her primary care physician.
In the ED, blood counts were noted to be abnormal. White blood cell count was 2.9k with neutrophils 8% and lymphocytes 89%, hemoglobin 4.2 g/dL, and platelet count 6k.
Bone marrow examination revealed cellularity of 100% with 80% blasts expressing CD19, CD10, CD34, HLA-DR, CD38, CD43, CD22, and CD24. FISH and PCR for the BCR-ABL translocation were negative.
No Ph-like abnormalities were detected.
No malignant cells were identified in the cerebrospinal fluid.
The patient was initiated on treatment per CALGB 10403.