Acute lymphoblastic leukemia (ALL) is a malignant neoplastic disease in which B- or T-lineage cells of lymphocyte origin proliferate abnormally in the bone marrow. The abnormally proliferating primary cells may accumulate in the bone marrow and inhibit normal hematopoietic function, and may also invade tissues outside the bone marrow, such as meninges, lymph nodes, gonads, liver, etc. Acute lymphocytic leukemia early manifestations 1, sudden onset – leukemia onset more rapid, the course of the disease is short, especially in children and young people more. 2, fever – the first symptom of acute leukemia is mostly fever, can be manifested as flaccid fever, fever, intermittent fever or irregular fever, body temperature at 37.5 – 40 ℃ or higher. There is sometimes a feeling of coldness, but not chills. 3. Bleeding – is a common symptom of leukemia. Bleeding sites can spread throughout the body, especially in the nasal cavity, oral cavity, gums, subcutaneous and fundus of the eyes, but also intracranial, inner ear and visceral bleeding. 4. Anemia – Anemia can occur early, manifested as white face, dizziness, palpitations, etc. 5, hepatosplenomegaly – 50% of leukemia patients will develop hepatosplenomegaly, with acute lymphoblastic leukemia having the most significant hepatosplenomegaly. 6. Lymph nodes – The swelling of lymph nodes is widespread throughout the body and is more common in acute lymphocytic leukemia, but is less pronounced in acute lymphoma than in slow lymphoma. Superficial lymph nodes are found in the neck, submandibular, axillary and inguinal areas, while deep lymph nodes are found in the mediastinum and near the internal organs. The enlarged lymph nodes are generally soft or moderately hard, with a smooth surface and no pressure pain or adhesions. 7. Skin and mucosal lesions – Skin lesions accompanying leukemia are manifested as nodules, lumps, maculopapular rashes, etc. Mucosal damage is manifested by swelling and ulceration of the nasal mucosa, respiratory mucosa, and oral mucosa, etc. 8, neurological inflammation – leukocyte infiltration can occur in the arachnoid membrane, meninges, etc., and behaves rather like brain tumors, meningitis, etc. Patients may experience increased intracranial pressure, meningeal irritation, limb paralysis and other symptoms. 9. Bone and joint lesions – After the lesions infiltrate the bones and joints, bone and joint pain often occurs, manifesting as hidden pain, soreness and occasionally severe pain in the sternum, humerus, as well as the shoulder, elbow, hip and knee joints. Acute lymphoblastic leukemia in children mostly presents with bone and joint pressure pain. 10.Other – Leukemia cells may infiltrate the respiratory, digestive and genitourinary systems, as well as the orbit, lacrimal gland and fundus of the eye. Patients may have diffuse or nodular changes in the lungs, accompanied by pleural effusion, digestive disorders, proteinuria, hematuria, amenorrhea or excessive menstruation, protruding eyes, vision loss and other symptoms.