Acute Lymphatic Leukemia in Childhood

Acute lymphatic leukemia is not infrequently encountered in childhood and presents little difficulty in differential diagnosis when the typical clinical and hematologic features are present. In many instances, however, atypical manifestations may cloud the picture to the extent that the diagnosis becomes more difficult. This is particularly true when the total leukocyte count is not significantly elevated and the differential formula does not present the usual preponderance of immature cells. It is now recognized that these instances of so-called "aleukemic" or "subleukemic" forms of lymphatic leukemia are not rare but constitute a considerable proportion of the total number of cases. In order to compare the incidence, course and manifestations of this aleukemic form with those of the more typical variety, with an elevated leukocyte count, we have reviewed the cases of 61 consecutive patients with acute lymphatic leukemia admitted to the pediatric service of the University Hospitals. Since all children