Tumours originating from T cells of the thymus form a subset of acute lymphoblastic leukaemia (ALL). These are similar in symptoms, investigation approach and management to other forms of ALL. Symptoms that develop, like other forms of ALL, relate to deficiency of platelets, resulting in bruising or bleeding; immunosuppression resulting in infections; or infiltration by cells into parts of the body, resulting in an enlarged liver, spleen, lymph nodes or other sites. Blood test might reveal a large amount of white blood cells or lymphoblasts, and deficiency in other cell lines - such as low platelets or anaemia. Immunophenotyping will reveal cells that are CD3, a protein found on T cells, and help further distinguish the maturity of the T cells. Genetic analysis including karyotyping may reveal specific abnormalities that may influence prognosis or treatment, such as the Philadelphia translocation. Management can include multiple courses of chemotherapy, stem cell transplant, and management of associated problems, such as treatment of infections with antibiotics, and blood transfusions. Very high white cell counts may also require cytoreduction with apheresis.