scholarly journals Acute Lymphoblastic Leukemia: Fourteen Years Experience of a Single Institution

2014 ◽  
Vol 34 (1) ◽  
pp. 1-6 ◽  
Author(s):  
KP Sah ◽  
PN Shrestha
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Acute Leukemia ◽  
Remission Rate ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Malignant Neoplasm ◽  
Bone Marrow Aspiration ◽  
Care Hospital ◽  
Female Ratio ◽  
Oncology Unit

Introduction: Leukemia commonly known as blood cancer is the most common malignant neoplasm in childhood accounting for about 41 % of all malignancies that occur in children younger than 15 year of age. The objectives of this study were to find out the clinico-laboratory features and survival of children with acute lymphoblastic leukemia (ALL) during fourteen years in pediatric oncology unit of a tertiary care hospital. Materials and Methods: This was a retrospective study conducted at Kanti Children’s Hospital (KCH) from March 1998 to March 2012. Bone marrow aspiration showing ≥25 % blast cells was the criteria for diagnosis of ALL. Results: Out of 755 childhood cancers reported in this hospital during study period, total number of Acute leukemia patients were 375 (49.7%). Among acute leukemia, patients with ALL were 300, which was 80.0 % among all leukemias and 39.7% of all cases of cancers. Among cases of ALL, L1, L2 and L3 constituted 163 (54.3%), 131 (43.7%) and 6 (2%) respectively. The age of the children with acute leukemia ranged from six months to fourteen years, with a mean age of 7.3 years. The majority of children (61.7 %) with ALL fell into the age group of 2-9 years. Males: Female ratio was (M:F=1.3:1 ). The most common presenting features in ALL were fever (89.2 %), followed by splenomegaly (89.1%), hepatomegaly (69.2%) and lymphadenopathy (58.4 %). Among all patients, remission rate was 28.3% at ≥ 5 years, 17.7% were on maintenance, 30.3% abandoned treatment and 23.7 % died. Conclusion: This study showed that the patients on remission at ≥ 5 years in this centre were 28.3%. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9056 J Nepal Paediatr Soc 2014;34(1):1-6

scholarly journals Immunophenotypic study of acute leukemia by flow cytometry at BPKMCH.

2013 ◽  
Vol 3 (5) ◽  
pp. 345-350
Author(s):  
S Shrestha ◽  
J Shrestha ◽  
CB Pun ◽  
T Pathak ◽  
S Bastola ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Acute Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Lymphoblastic Leukemia ◽  
Bone Marrow Examination ◽  
Myelogenous Leukemia ◽  
Female Ratio ◽  
Flow Cytometric ◽  
Male Female Ratio ◽  
Acute Myelogenous

Background: Immunophenotyping of acute leukemia is one of the most important clinical applications of fl ow cytometry. The aim of this study was to determine the immunophenotyping profi le of acute leukemia, by means of a fl ow cytometric method, using monoclonal antibodies all marked with a fl uorochrome, in four colour systems to assess their distribution according to type of leukemia (lymphoid B or T / myeloid). Materials and Methods: We retrospectively collected data of immunophenotyping from 52 acute leukemia patients at the department of pathology in B.P. Koirala Memorial Cancer Hospital from January 2010 to December 2011. Diagnosis was based on peripheral blood and bone marrow examination for morphology, cytochemistry and immunophenotypic studies. Results: Out of total 52 cases of acute leukemia diagnosed by fl ow cytometry over a two year period, there were 31 cases (59.6 %) of acute lymphoblastic leukemia, 20 cases (38.4 %) of acute myelogenous leukemia and one case (1.9 %) of bi-phenotypic acute leukemia. Leukemia was diagnosed among adults in 44.2 % whereas among children with age less than or equal to 15 years in 55.7 %. Thirty eight (73%) were male and 14 (27 %) were female with a male: female ratio of 2.7:1. For acute myelogenous leukemia, it was found that M0 (5.0 %), M1 (20%), M2 (60%), M3 (15%), M4 (5.0 %) were detected. CD13 and CD33 were the most useful markers in the diagnosis of acute myelogenous leukemia. The most common subtype was AML-M2. Of the 31 cases with acute lymphoblastic leukemia, 20 cases (64.5 %) were identifi ed as B-ALL and 11 cases (35.5%) as T-ALL. Aside from cytoplasmic CD3 (cCD3) and CD7 were the most sensitive antigens present in all cases of T-ALL. All cases of B-ALL showed expression of pan B-cell markers CD19 and CD22, but 15 (75 %) of 20 cases expressed CD10. Conclusion: Flow cytometric immunophenotyping was found to be especially useful in the correct identifi cation and diagnosis of acute myeloid or lymphoblastic leukemia and its subtypes. In combination with French-American-British (FAB) morphology and immunophenotyping, we were able to diagnose and classify all patients with acute leukemia in this study. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 345-350 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7856

scholarly journals CLINICOHEMATOLOGICAL, IMMUNOPHENOTYPING, MOLECULAR PROFILE, AND OVERALL SURVIVAL IMPACT IN ACUTE LYMPHOID LEUKEMIA PATIENTS FROM NORTH INDIA

2019 ◽  
pp. 164-171
Author(s):  
MANOJ KUMAR ◽  
MOHIT CHOWDHRY ◽  
RAJ NATH MAKROO ◽  
DEEPIKA RANI ◽  
VANDANA SHARMA ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Chromosomal Abnormalities ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
North India ◽  
Molecular Profile ◽  
Pathophysiological Mechanism ◽  
Care Hospital ◽  
Molecular Subgroup ◽  
Lymphoid Leukemia

Objective: Cytogenetic plays an inevitable role in predicting the diagnosis of acute leukemia. The recurrent chromosomal aberrations in acute leukemia have provided critical insights into the pathophysiological mechanism of leukemogenesis. Cytogenetics findings at diagnostics provide important information for decision-making in both childhood and adult acute lymphoblastic leukemia (ALL). The cure rate for ALL is >80% in children and 35% in adults. Despite the therapeutic advances in ALL, several important biological and pathophysiological questions remain to be answered to achieve an accurate diagnosis, timely prognosis, and maximum therapeutic benefit. Methods: The present study was carried out at tertiary care hospital, New Delhi, India. A total of 144 newly diagnosed ALL patients were analyzed for clinicohematological profile, immunophenotyping, conventional, and molecular cytogenetics. Results: The study population was found to have normal karyotypes in most of the cases; however, abnormalities also reported. Our study clearly indicates that the application of fluorescence in situ hybridization has increased sensitivity and accuracy for detecting various chromosomal abnormalities, more so with the cryptic rearrangements. Conclusion: We observed that the prevalence of the molecular subgroup of leukemia with a potential for a favorable clinical outcome (ETV6-RUNX1 and hyperdiploidy) in precursor B-ALL is higher in the North India.

Profound Hyperbilirubinemia during Induction of Adult Acute Lymphoblastic Leukemia: Capping L-Asparaginase Dose to 10,000 Units Attenuates It without Compromising Remission Rate.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4531-4531 ◽  
Author(s):  
Amish D. Vora ◽  
Vasnat R. Pai ◽  
Prabhash Kumar ◽  
Shripad Banavali ◽  
Reena Nair ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Remission Rate ◽  
Standard Dose ◽  
Lymphoblastic Leukemia ◽  
Dose Intensity ◽  
Fixed Dose ◽  
Full Cohort ◽  
Term Survival ◽  
Female Ratio ◽  
Adult Acute Lymphoblastic Leukemia

Abstract Introduction: Hyperbilirubinemia is a well known side-effect of L-asparaginase. Grade 4 hyperbilirubinemia (bilirubin > 3) results in delayed chemotherapy; compromising dose intensity. Hence a strategy to prevent this is important. Materials & Methods: At our center, we see around 125 cases of newly diagnosed adult acute lymphoblastic leukemia (age>24 years) every year. Since 2005, we have started treating these adult patients on modified BFM 90 protocol. This protocol includes 8 doses of L-asparaginase at 10,000 units/m2 during induction. Hyperbilirubinemia of grade 4 (median bilirubin upto 20) was encountered in the first few patients. To avoid delay in chemotherapy, we modified the protocol to cap L-asparaginase dose at 10,000 u for all patients. Results: A total of 64 patients with ALL was treated on this modified protocol in 18 months. We compared the degree of hyperbilirubinemia in this group of patients with the first 20 patients who were treated with the standard dose of L-asparaginase. Median age of the full cohort (All 84 patients) was 34 years (24–60). Fifty four patients had precursor B-cell ALL while 30 patients had T-cell ALL. Male: Female ratio was 4.1:1. All the analysed patients have completed induction. In first group of 20 patients who had received standard dose of L-asparaginase, 6 patients developed grade 4 hyperbilirubinemia (median bilirubin 23). SGPT, SGOT and SAP were either normal or borderline elevated. Viral markers at diagnosis and at the onset of hyperbilirubinemia were negative. No significant hepatic abnormality was seen on USG abdomen. In four out of 6 patients’ bilirubin returned to normal after conservative management, over a period of 3 weeks. The two remaining patients developed sepsis, had deranged coagulation parameters and succumbed to sepsis. Of the second group of 64 patients ( L-asparaginase at 10,000 fixed dose), 5 patients developed hyperbilirubinemia (highest value of bilirubin 4). All other investigations (listed above) were normal.All patients’ bilirubin came back to normal within 1 week of interruption of chemotherapy. Complete remission rates were 90% in the first group of 20 patients and 92% in the second group of 64 patients. Conclusion: In the cohort of 64 patients (second group), capping of L-asparaginase resulted in significant reduction in intensity, incidence and duration of hyperbilirubinemia. This modification did not affect CR rate, though we are currently evaluating long term survival to confirm sustained efficacy.

scholarly journals ACUTE LYMPHOBLASTIC LEUKEMIA; CHROMOSOMAL ABNORMALITIES IN CHILDHOOD REPORTING AT A TERTIARY CARE HOSPITAL OF SINDH

2016 ◽  
Vol 23 (03) ◽  
pp. 312-316
Author(s):  
Dr. Ghulam Shah Nizzamani ◽  
Zaheer Ahmed Nizamani ◽  
Dr. Amin Fahim ◽  
Dr. Ikram Uddin Ujjan
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Chromosomal Abnormalities ◽  
Tertiary Care Hospital ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Medication errors in a cohort of pediatric patients with acute lymphoblastic leukemia on remission induction therapy in a tertiary care hospital in Mexico

2019 ◽  
Vol 8 (13) ◽  
pp. 5979-5987 ◽  
Author(s):  
Edmundo Vázquez‐Cornejo ◽  
Olga Morales‐Ríos ◽  
Luis E. Juárez‐Villegas ◽  
Erika J. Islas Ortega ◽  
Felipe Vázquez‐Estupiñán ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Medication Errors ◽  
Induction Therapy ◽  
Pediatric Patients ◽  
Tertiary Care Hospital ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Remission Induction ◽  
Care Hospital

scholarly journals Spectrum of Pediatric Malignancies: An Observational Single Center Study from Western India

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Aditi Mittal ◽  
Kanu Neemawat ◽  
Sandeep Jasuja ◽  
Anushree Chaturvedi
Keyword(s):  
Pediatric Cancer ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Western India ◽  
Care Hospital ◽  
Female Ratio ◽  
Pediatric Malignancies ◽  
Children And Adolescent ◽  
Low Middle Income Countries ◽  
Distinguished Group

Cancer is a leading cause of death for children and adolescent worldwide. The cure rates in low middle-income countries are dismal (20%) in comparison to high income countries (80%). The first move is to assemble precise data on epidemiology of pediatric cancer across the country and its region wide variation. This study attempts to provide spectrum of pediatric malignancies from a tertiary care hospital in the state of Rajasthan, India. A total of 140 cases were studied retrospectively over a period of two years (April 2018-March 2020). Patients, 0-18 years of age that are diagnosed as a case of malignancy were included in this study. The records of these patients were retrieved and analyzed. Patients were stratified in 4 groups; 0-4 years, 5-9 years, 10-14 years and 15-18 years. Most of the patients fell in 15-18 year group (35.7%), followed by 5-9 year group (28.5%). Majority of cases, 67.8% were male. The male to female ratio is 2.1:1. Leukemia (40%) was the most common malignancy followed by lymphoma, retinoblastoma and malignant bone tumors. Acute lymphoblastic leukemia comprises majority (35/56) of leukemia. Retinoblastoma was predominant malignancy among <5-year children. In all other groups, leukemia was predominant. This study gauges the trend of pediatric malignancies at one of the largest tertiary care hospitals in Rajasthan, which is important in the planning and evaluation of health strategies. As we lack a dedicated pediatric cancer registry, such epidemiological studies play a significant part for this small but distinguished group of patients.

scholarly journals Demographic features of pediatric B-ALL (B Lineage Acute Lymphoblastic Leukemia) patients in Pakistani population.

2020 ◽  
Vol 27 (08) ◽  
pp. 1582-1589
Author(s):  
Moizza Sahar ◽  
Saira Gul ◽  
Farhana Shehzad ◽  
Shahida Mohsin
Keyword(s):  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Care Hospital ◽  
Pakistani Population ◽  
Pediatric All ◽  
B Lineage ◽  
Standard Risk ◽  
Demographic Features

Objectives: This study was conducted to evaluate demographic features of pediatric B-ALL patients in Pakistani population and their prognosis in a Tertiary Care Hospital. Study Design: Descriptive study. Setting: Department of Pathology Tertiary Care Children Hospital, Lahore. Period: 1st January 2016 to 31st December 2016. Material & Methods: A total of 66 samples of newly diagnosed B-ALL patients (aged 1-15 years) were taken for study. For diagnosis of B-ALL, bone marrow aspiration, cytochemical staining, immunophenotyping was done. Results: Out of 66 B-ALL patients, 35 (53%) were males and 31 (47%) were females. The median age for pediatric ALL subjects was 5 years. Out of 66 B-ALL patients, 39 (59%) were in standard risk group. The prognosis of ALL patients in our study was poor as compared with international statistics with 12/21 deaths (57%) in standard risk group. Also, history of consanguinity of parents was significantly high in dead patients (p = 0.013). Deaths were also comparatively more in males than in females. Conclusion: The prognosis of pediatric B-ALL patients in our study was poor as compared with international statistics because of multifactorial reasons. Strategies are needed to be adopted to improve the outcome of B-ALL patients in our population.

scholarly journals Clinico-Haematological Study of Pancytopenia – An Experience from a Tertiary Care Centre in Western Odisha

2021 ◽  
Vol 8 (24) ◽  
pp. 2052-2057
Author(s):  
Anupa Toppo ◽  
Harish Chandra Singh ◽  
Rojalin Nanda
Keyword(s):  
Bone Marrow ◽  
Aplastic Anaemia ◽  
Tertiary Care ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Megaloblastic Anaemia ◽  
Care Hospital ◽  
Haematological Malignancies ◽  
Female Ratio ◽  
Haematological Disorders

BACKGROUND Pancytopenia is a relatively common haematological entity with simultaneous presence of anaemia, leucopenia and thrombocytopenia. It is a feature of many medical and haematological disorders like megaloblastic anaemia, drug-induced bone marrow hypoplasia, even fatal leukaemia and bone marrow aplasia. The clinical and haematological studies determine the proper diagnosis and management of patients. Bone marrow examination is an important diagnostic procedure for determining the cause of pancytopenia. This study was conducted to evaluate clinico-haematological findings, identify the causes of pancytopenia, and compare our findings with other similar studies. METHODS The four-year retrospective study was carried out in the Department of Pathology at a tertiary care hospital in western Odisha, India. Data regarding clinical details, peripheral blood and bone marrow aspirations were collected and analyzed using simple statistical methods. RESULTS A total of 131 cases of pancytopenia were studied. The age range of patients was 3 years to 72 years, with a mean of 36.5 years. Male to female ratio was 0.84 : 1. The majority of cases were in the age group of 31 – 40 years (20.61 %). Generalized weakness with pallor (54.96 percent) was the commonest clinical finding, followed by splenomegaly (16.79 %), and hepatomegaly (11.45 %). Aplastic anaemia (43.51 %) was the most common cause found on the bone marrow aspiration followed by megaloblastic anaemia (22.14 %) and haematological malignancies. Among the haematological malignancies, acute myeloid leukaemia was the commonest cause of pancytopenia (10.69 %). CONCLUSIONS Bone marrow aspiration in cytopenic patients helps in understanding the disease process and to diagnose or rule out the causes of cytopenia. Different geographical areas have a different presentation of haematological disorders. KEYWORDS Bone Marrow Aspiration, Pancytopenia, Aplastic Anaemia

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