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

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

Case Reports in Hematology ◽

10.1155/2020/8889850 ◽

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.

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Introduction to haematology

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0510 ◽

2020 ◽

pp. 5169-5171

Author(s):

Chris Hatton

Keyword(s):

Bone Marrow ◽

Weight Loss ◽

Diagnostic Tests ◽

Blood Count ◽

Modern Medicine ◽

Blood Film ◽

Full Blood Count ◽

Cellular Infiltration ◽

Haematological Disorder ◽

History Of

Haematology is the study of the composition, function, and diseases of the blood. The approach to a patient suspected of having a haematological disorder begins with taking a history (particularly noting fatigue, weight loss, fever, and history of bleeding) and performing a clinical examination (looking for signs of anaemia, infection, bleeding, and signs of cellular infiltration causing splenomegaly and/or lymphadenopathy). Key investigations include a full blood count, a blood film, and (in selected cases) examination of the bone marrow. Further diagnostic tests now routinely performed on blood and marrow samples include immunophenotyping and cytogenetic and molecular analysis. Mutational signatures may be diagnostically useful and potentially define treatment, keeping haematology in the vanguard of advances in modern medicine.

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Diagnosis and investigation in haematology

10.1093/med/9780199568741.003.0278 ◽

2018 ◽

Author(s):

Chris Bunch

Keyword(s):

Bone Marrow ◽

Blood Count ◽

Iliac Crest ◽

Bone Marrow Examination ◽

Needle Aspiration ◽

Blood Film ◽

Full Blood Count ◽

Clinical Context ◽

Posterior Iliac Crest ◽

Haematological Disorders

This chapter addresses the interpretation of the full blood count, blood film, bone marrow examination, and related tests in the diagnosis of haematological disorders. Examination of a stained blood film, which should always be requested if a blood count abnormality cannot readily be explained by the clinical context, may give clues to the cause of the abnormality or prove diagnostic. Examination of the bone marrow is essential to the proper evaluation and diagnosis of many haematological disorders. The simplest form of marrow examination involves needle aspiration of marrow cells from the posterior iliac crest; smears are made and stained in the same way as a blood film. Bone marrow can also be biopsied for histological examination, at the same time as marrow aspiration.

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

Malaysian Journal of Paediatrics and Child Health ◽

10.51407/mjpch.v27i2.139 ◽

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.

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Bloodstream infection caused by Acinetobacter junii in a patient with acute lymphoblastic leukaemia after allogenic haematopoietic cell transplantation

Journal of Medical Microbiology ◽

10.1099/jmm.0.024596-0 ◽

2011 ◽

Vol 60 (3) ◽

pp. 375-377 ◽

Cited By ~ 11

Author(s):

Rodrigo Cayô ◽

Lucrecia Yañez San Segundo ◽

Inmaculada Concepción Pérez del Molino Bernal ◽

Celia García de la Fuente ◽

Maria Aranzazu Bermúdez Rodríguez ◽

...

Keyword(s):

Acute Lymphoblastic Leukaemia ◽

Bloodstream Infection ◽

Clinical Significance ◽

Lymphoblastic Leukaemia ◽

Transplant Patient ◽

Paediatric Oncology ◽

Correct Identification ◽

Human Pathogen ◽

Acinetobacter Junii ◽

Haematopoietic Cell

Acinetobacter junii is a rare human pathogen associated with bacteraemia in neonates and paediatric oncology patients. We present a case of A. junii causing bacteraemia in an adult transplant patient with leukaemia. The correct identification of Acinetobacter species can highlight the clinical significance of the different species of this genus.

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