Revisiting the complete blood count and clinical findings at diagnosis of childhood acute lymphoblastic leukemia: 10-year experience at a single center

Abstract

BackgroundHeterogeneity regarding clinical and laboratory findings at diagnosis of acute lymphoblastic leukemia exists. The frequency of complete blood count abnormalities and its combinations, symptoms and physical findings were investigated in Hispanic children from an open population at the diagnosis of acute lymphoblastic leukemia.MethodsThe patient charts and electronic records of under 16-year-old children diagnosed with acute lymphoblastic leukemia over 10 years at a regional hematology center of a university hospital were analyzed to retrieve data concerning the complete blood count at first evaluation. Type and distribution of abnormal data, frequency of symptoms and physical findings at presentation were documented.ResultsThe records of 203 children aged 0–15 years diagnosed with acute lymphoblastic leukemia from 2006 to 2016 were revisited. The results of the blood workup showed a median white blood cell count of 7120 × 109/L (range: 450–600,000 × 109/L), and a median hemoglobin concentration of 7.5 g/dL (range: 2.4–15.3 g/dL), whereas the median platelet count was 47,400 × 109/L (range: 4000–544,000 × 109/L). Leukocytosis and leukopenia were present in 36.6% and 36.1% of cases, respectively; anemia was diagnosed in 82.9% children. The order of frequency for major clinical symptoms was fatigue 62%, fever 60%, bone and joint pain 39%, hyporexia 33% and weight loss 21%, while main physical findings were hepatomegaly 78%, splenomegaly 63%, lymphadenopathy 57%, pallor 48%, and purpura 30%.ConclusionData differing from those classically expected at diagnosis of acute lymphoblastic leukemia in children were documented in a cohort of Hispanic children over one decade with a wide spectrum of complete blood count abnormalities, forms of presentation and frequency of physical findings.

Clinical Characteristics and Outcome After Induction of Chemotherapy in Pediatric Acute Lymphoblastic Leukemia: A Descriptive and Correlational Study From the West Bank of Palestine

“…Hemoglobin levels differed signi cantly between children older and younger than 5 years and those who had T-ALL or B-ALL. Findings of this study were consistent with those reported in previous studies [10,25]. The median platelet count was 80,000 with an IQR of 157000 platelets/mm3.…”

“…Similarly, the absolute neutrophils counts were also signi cantly different between patients who had T-ALL and B-ALL. Our ndings were consistent with the reported complete blood count and clinical ndings of patients with pediatric ALL [10].…”

Considerations on the Hematologic Toxicity of the all IC-BFM 2002/2009 Therapeutic Protocol in Children with Acute Lymphoblastic Leukemia

“…They will require blood product transfusions which, at their turn, will generate other possible complications (allergic reactions, infections) [11][12][13][14].…”

“…Medullary aplasia represents the most dangerous picture which may occur after chemotherapy and its seriousness is given by the possibility for an infectious clinical picture to occur, which may lead to septicemia, to a hemorrhagic syndrome or to mucosal lesions associated with hemorrhage and necrosis [7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Descripción de líneas celulares sanguíneas de pacientes con blastos provenientes de cinco ciudades de Colombia. Serie de casos

“…Varios estudios, incluidos el de Jiménez (16) y el de Jaime Pérez (17) , mostraron que la mayoría de los pacientes consultó por síndrome anémico, con un porcentaje de 84 % y 82,9 %, respectivamente. Tal como se describe en Wintrobe's Clinical Hematology, la anemia se presenta en todas las neoplasias hematológicas, la magnitud refleja la gravedad de la enfermedad y la fisiopatología se relaciona con la disminución en la producción de eritrocitos (15) .…”