scholarly journals Extensive Bone Marrow Necrosis: A Rare Presentation of Acute Lymphoblastic Leukaemia

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
I. Ranathunga ◽  
N. R. Muthumala ◽  
H. W. C. K. Kulathilake ◽  
S. Weerasinghe ◽  
N. L. A. Shyamali
Keyword(s):  
Bone Marrow ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Bone Marrow Aspiration ◽  
Blood Film ◽  
Lymphoid Cells ◽  
Severe Neutropenia ◽  
Bone Marrow Necrosis ◽  
Rare Presentation ◽  
Extensive Necrosis

Background. Bone marrow necrosis (BMN) is a rare entity which presents with bone pain, fever, and peripheral cytopenia. Acute lymphoblastic leukaemia (ALL) is characterized by malignant proliferation of immature lymphocytes, and patients usually present with fatigue and bleeding manifestations. Presentation with BMN is an extremely rare finding and only few cases had been reported in the literature. Case Presentation. A 22-year-old male presented with nocturnal lower back ache, pleuritic central chest pain, and fever for two weeks. He was extensively investigated for a cause. His investigations revealed pancytopenia with severe neutropenia. Initial bone marrow aspiration and biopsy did not provide a positive result due to extensive necrosis. However, immunohistochemical analysis of few immature lymphoid cells on repeated BM biopsy showed evidence of acute lymphoblastic leukaemia. Conclusions. ALL usually presents with fatigue and bleeding manifestations. Presentation with BMN is extremely rare. The diagnosis was extremely challenging as this patient had only occasional atypical cells in the peripheral blood film and the repeat bone marrow (BM) biopsy showed extensive necrosis.

scholarly journals REMISSION RATE OF PRE-B ALL (ACUTE LYMPHOBLASTIC LEUKEMIA) AFTER INDUCTION CHEMOTHERAPY FOLLOWING UNITED KINGDOM ACUTE LYMPHOBLASTIC LEUKAEMIA 2011 (UKALL 2011) TRIAL PROTOCOL

2021 ◽  
Vol 71 (2) ◽  
pp. 469-72
Author(s):  
Hafiz Muhammad Murtaza ◽  
Tariq Ghafoor ◽  
Muhammad Shaheen Iqbal
Keyword(s):  
Bone Marrow ◽  
United Kingdom ◽  
Acute Lymphoblastic Leukaemia ◽  
Induction Chemotherapy ◽  
Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukemia ◽  
Bone Marrow Aspiration ◽  
Military Hospital ◽  
Induction Treatment ◽  
Blast Cells

Objective: To find out the rate of remission of Pre-B Acute Lymphoblastic Leukaemia in children at the end of induction treatment with United Kingdom Acute Lymphoblastic Leukaemia (UKALL) 2011 chemotherapy protocol. Study Design: Prospective observational study. Place and Duration of Study: Paediatric Oncology Unit, Combined Military Hospital Rawalpindi, from Nov 2017 to Oct 2018. Methodology: Data of newly diagnosed patients of Pre-B Acute lymphoblastic Leukaemia, between 1 and 15 years of age was analysed. Patients were divided into low and high-risk groups and treated with United Kingdom Acute Lymphoblastic Leukaemia 2011 induction chemotherapy on regimens A and B respectively. Bone marrow aspiration was performed at the end of induction therapy (28 days), to document their remission status. Patients having ≤5% of blast cells were categorized to be in remission state and those with >5% blast cells were not considered in a state of remission. Results: A total of 79 patients, 45 (57%) male and 34 (43%) females were enrolled. The mean age was 5.79 ± 3.59 years. Fever (86.1%) and pallor (77.2%) were the most common presentations. Fifty-three (67.1%) patients were treated with regimen A and 26 (32.9%) had regimen B chemotherapy. Febrile neutropenia and myopathy were the most common complications seen in 73 (92.4%) and 54 (71.1%) patients respectively. Eight patients (10.1%) died during induction chemotherapy. Bone marrow aspiration done at the end showed a 100% rate of remission for both regimens A and B. Conclusion: Risk-based treatment of paediatric Acute lymphoblastic Leukaemia............

scholarly journals Orbital Swelling: An Unusual Case of Relapsed Acute Lymphoblastic Leukaemia in A Preschool Child

2021 ◽  
Vol 27 (2) ◽  
pp. 19-22
Author(s):  
Muhammad Amiro Rasheeq Mohd Radzi ◽  
Ariffin Nasir ◽  
Shatriah Ismail ◽  
Razan Hayati Zulkeflee ◽  
Juhara Haron ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Bone Marrow ◽  
Nervous System ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Bone Marrow Failure ◽  
Clinical Findings ◽  
Blood Film ◽  
Central Nervous System Relapse ◽  
Leukaemic Cells

Acute lymphoblastic leukaemia (ALL) is the most frequent childhood cancer. Children usually present with signs of bone marrow failure like recurrent or prolonged fever, pallor, lethargy, bleeding tendencies, bone pain and others. Occasionally they may present with sign of infiltration of leukaemic cells into other organs such as testicular and central nervous system, rarely to the periorbital or orbital region. Similarly in relapse cases, they typically presented either in bone marrow, central nervous system relapse or testicular but rarely orbital involvement.  Here we report the clinical case of a five-year-old boy who developed relapsed B-ALL, presented to us with unilateral right eye swelling without other clinical findings and absence of blast cells in the peripheral blood film as well as bone marrow aspirate specimen.

scholarly journals Analysis of Full Blood Count and Bone Marrow Aspirations at Presentation in Children Diagnosed with Acute Leukaemias – A Single Centre Experience in Southern Nigeria

2021 ◽  
pp. 1-8
Author(s):  
G. K. Eke ◽  
K. I. Korubo
Keyword(s):  
Bone Marrow ◽  
Acute Lymphoblastic Leukaemia ◽  
Teaching Hospital ◽  
Lymphoblastic Leukaemia ◽  
Blood Count ◽  
Paediatric Oncology ◽  
Blood Film ◽  
Full Blood Count ◽  
Malignant Neoplasms ◽  
Southern Nigeria

Introduction: Acute leukaemias are the most common malignant neoplasms in childhood, presenting with a variety of nonspecific symptoms. Though many of the recent more sophisticated methods of diagnosis have important prognostic implications, they are often not available in low- and middle-income countries. Objective: To review the full blood count and bone marrow aspirations at presentation in children diagnosed with acute leukaemias at a teaching hospital in southern Nigeria. Methodology: A retrospective survey of children with acute leukaemias admitted into the Paediatric Oncology unit of the University of Port Harcourt Teaching Hospital (UPTH), from January 2014 to December 2020. Their clinical profile, full blood count and bone marrow aspirations were analyzed using SPSS version 25.0 Results: Forty-three children aged 8 months to 17 years, with a median age of 9 years, were diagnosed with acute leukaemia within the period under review, 28 (65.1%) were males and 15 (34.9%) females, giving a M:F ratio of 1.9:1. Commonest clinical features at presentation were fever (n=28, 65.1%), pallor (n=18, 41.9%) and gum bleeding (n=16, 37.2%); while 38 (88.4%) of them presented with anaemia, 20 (46.5%) had leukocytosis and 36 (83.7%) had thrombocytopoenia with a median platelet count of 42x109/L and circulating blasts were present in the peripheral blood film of most of the patients. Acute lymphoblastic leukaemia (ALL) was the diagnosis in 30 (70%) children, and AML in 9 (21%). The bone marrow was hypercellular in 30 cases (69.8%) and erythropoiesis was depressed in 39 (90.7%) children. Conclusion: At the UPTH, children with acute leukaemias were mostly males. Fever, pallor and gum bleeding were the commonest symptoms with most of them having circulating blasts. Acute lymphoblastic leukaemia was the commonest type and bone marrow was mainly hypercellular with depressed erythropoiesis.

Bone Marrow Necrosis in Acute Lymphoblastic Leukaemia

1987 ◽  
Vol 32 (6) ◽  
pp. 177-180 ◽  
Author(s):  
H.W. Habboush ◽  
I.M. Hann
Keyword(s):  
Bone Marrow ◽  
Complete Remission ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Bone Marrow Necrosis ◽  
Prognostic Features ◽  
Remission Duration ◽  
Prognostic Feature ◽  
Poor Prognostic Feature ◽  
Low Rate

Bone marrow necrosis, an uncommon finding in acute lymphoblastic leukaemia, has previously been regarded as a poor prognostic feature. It has been associated with difficulty in establishing the diagnosis, a low rate of remission as well as short remission duration. We report a case of bone marrow necrosis in a girl with acute lymphoblastic leukaemia and good prognostic features who attained complete remission uneventfully and will discuss previous reports of this association in the literature.

Acute Lymphoblastic Leukaemia: A Case Report of Long-term Disease-free Survival in a Resource Limited Setting

2020 ◽  
Vol 3 (4) ◽  
pp. 457-462
Author(s):  
ED Jatau ◽  
DE Joseph ◽  
JO Egesie ◽  
OD Damulak ◽  
TO Piwuna ◽  
...  
Keyword(s):  
Case Report ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Disease Free Survival ◽  
Bone Marrow Aspiration ◽  
Lymphoid Cells ◽  
Full Blood Count ◽  
Clinical Relapse ◽  
High Index Of Suspicion ◽  
Disease Free

Acute Lymphoblastic Leukaemia (ALL) a malignant proliferation of immature lymphoid cells is a biologically heterogeneous disorder with variable outcomes in adults. We present a case report of a 54-year-old woman who presented with fever, anaemia and peripheral lymphadenopathy of four weeks duration, and was managed for disseminated tuberculosis initially. Full blood count and bone marrow aspiration cytology constituted part of her initial investigations and were found to be in keeping with acute lymphoblastic leukaemia (ALL-L3). Patient had supportive treatment and managed with Cyclophosphamide, Vincristine (Oncovin), Cytosine Arabinoside and Prednisolone (COAP Regimen), achieved complete clinical and haematologic remission, and has remained disease free after consolidation and maintenance therapy. No evidence of haematologic or clinical relapse at five years and currently in her ninth-year post diagnosis and treatment. With high index of suspicion, timely investigation and referral, satisfactory outcomes are achievable in managing some patients with acute lymphoblastic leukaemia.

BONE-MARROW TRANSPLANTATION IN HIGH-RISK ACUTE LYMPHOBLASTIC LEUKAEMIA IN FIRST AND SECOND REMISSION

The Lancet ◽  
1987 ◽  
Vol 329 (8536) ◽  
pp. 786-789 ◽  
Author(s):  
RogerH. Herzig ◽  
A. John Barrett ◽  
Eliane Gluckman ◽  
StevenJ. Jacobsen ◽  
Tohru Masaoka ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
High Risk ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Marrow Transplantation
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