What are the key clinical features that should raise suspicion for Acute Lymphoblastic Leukaemia (ALL) in a child?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Key clinical features that should raise suspicion for acute lymphoblastic leukaemia in a child include:

  • General symptoms: Persistent fatigue, unexplained fever, and unexplained and persistent infections .
  • Haematological signs: Unexplained petechiae, unexplained bleeding or bruising, and pallor .
  • Lymphatic and organ enlargement: Generalised lymphadenopathy and unexplained hepatosplenomegaly .
  • Skeletal symptoms: Persistent or unexplained bone pain .

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