Leukemias in children - A clinico-haematological study
Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 7, Issue 3
Abstract
Background: Ease and repeatability of sampling of blood cells have grabbed much of the interest of scientists over the world towards leukemia. Leukemia is the most common malignancy seen in children, most of them being acute. So the present study was planned to highlight the clinico-haematological features of childhood leukemia in tertiary care hospital. Methodology: The present study was conducted in a tertiary care hospital for two years of duration. All the cases between 0 to 14 years of age were included in the study. Patient was evaluated with complete blood count, peripheral smear, bone marrow examination and cytochemistry consisting of Myeloperoxidase (MPO) and Periodic Acid Schiff (PAS) stain. Immunophenotypic and Cytogenetic findings were recorded from the case records in available cases. An attempt was made to follow up the cases. Results: There were 60 cases of childhood leukemia. The mean age was 6.58 years with 36 males, 23 females and 1 case of congenital leukemia with ambiguous genitalia. Commonest presenting features were anemia, fever and organomegaly. Acute lymphoblastic leukemia (ALL) was the commonest-44 cases (73.3%); L1- 29, L2- 12, L3- 3. Immunophenotype was available in 30 cases of ALL: B-ALL-23, T-ALL-7. Two cases of B-ALL had an associated Burkitt lymphoma. 8.3% of ALL had pancytopenia and another 8.3% had a normal leucocyte count. These required bone marrow examination for the diagnosis. There were 12 cases of acute myeloid leukemia (AML). The entire spectrum of AML was seen with AML M-2 being the most frequent. Congenital AML with Down syndrome were seen in 2 cases. We had 2 cases of chronic myeloid leukemia (CML) both in chronic phase and with BCR-ABL positivity. There were 2 cases of Juvenile yelomonocytic leukemia (JMML) which were BCR-ABL negative. Conclusions: Acute leukemia is more common in paediatric age group. Myeloid differentiation was also seen in our study including CML and JMML. The use of cytochemistry, immunophenotyping and cytogenetics have become equally important and conclusive for arriving at a specific diagnosis.
Authors and Affiliations
Daksha P Prabhat, Saaishta Rangwala, Tejaswini Waghmare
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