Presenting Clinical and Laboratory Data of Childhood Acute Lymphoblastic Leukemia

BackgroundLeukemia is the most prevalent childhood cancer and Acute Lymphoblastic Leukemia (ALL) constitutes 75% of all cases. The most frequent presenting symptoms are fever, weight loss and pallor. Early detection of clinical symptoms positively affects timely diagnosis. The objectives of the present study were to assess frequency of presenting symptoms, laboratory data, immune phenotypes and prognostic factors in children with diagnosis of ALL. Materials and MethodsWe performed a prospective follow-up study of 100 patients aged 1-16 years diagnosed with ALL, admitted to Shahid Sadoughi hospital pediatrics ward from March 2006 to February 2010. Demographic and biochemical data were obtained from their medical record. Data were analyzed using SAS 9.1.3 software.ResultsThe mean of patients’ ages was 9 years. Complete blood cell count was abnormal in all of the patients, and pancytopenia was detected in 27% of the patients. Of all the patients, 25% had abnormal white blood cell (WBC) count at presentation, 37% had leucopenia and 38% had leukocytosis. WBC count was above 50,000/mm³ in 22% of cases. Anemia was detected in 85% of the patients. There was no significant sex difference, but a significant age difference existed among patients (p <. 05).According to flowcytometry results, 61% of patients had T-cell and 39% had B-cell immune phenotype. The frequency of undesirable prognostic factors was more in T-cell than the B-cell group, but this difference was only significant for male patients (p<0.05).The most common presenting symptoms were systemic symptoms, which comprised of lethargy and malaise in 81%, anorexia in 72%, pallor in 69% and fever in 59% of cases. Musculoskeletal system was the most common system involved.ConclusionIn our study, T-cell immune phenotypes comprised the most frequent form of ALL in children. The presence of male sex and high WBC count could make its outcome worse. However, on time chemotherapy could alter the outcome of these patients.