The acute lymphoid leukemia (ALL) is a neoplasia characterized by the proliferation of clonal cells lymphoid. In pediatric patients, ALL accounts about 77% of all the leukemias, but in adults, the frequency varies according to the geographic location. The muscular atrophy is common in patients with cancer as a result of the protein catabolism caused by different factors produced by the tumor and contributes increasing inflammation, also considering the adverse effects originated by immunosuppressant drugs, and causing sedentary lifestyle and prolonged rest syndrome. An atypical case of leukemia severe lymphoid is presented with multiple lytic lesions in backbone, pelvis and cranium, besides vertebral crush fractures and spinal cord infiltration data, so the intervention of the physiotherapeutic management with the objective of pain control, increased skeletal muscle function, decrease of fatigue and increase the quality of life is considered indispensable within the multidisciplinary management.
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