Immunophenotypic Pattern and Treatment Outcome after Completion of Induction Remission in Children with Acute Lymphoblastic Leukemia

Abstract

Background: Acute lymphoblastic leukemia (ALL) is presented with different immunophenotypic pattern.
 Objective: The purpose of the study was to evaluate the immunophenotypic pattern of ALL and also, to recognize the frequency of different ALL subtypes and treatment outcome after induction remission therapy.
 Methodology: This prospective study was conducted in the Department of Paediatric Hematology and Oncology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from June 2017 to July 2018 for a period of one year. Newly diagnosed admitted cases of ALL aged 1 to 17.9 years were included. Immunophenotyping from aspirate marrow samples were done in a special hematology laboratory. Patients were monitored during induction remission period with physical examination and required investigations.
 Result: Among 87 analyzed patients, 81 patients (93.1%) were B-cell ALL and 6 patients (6.9%) were T-cell ALL. After completion of induction remission therapy 61 patients had undergone complete remission and among them B cell ALL were 56(69.1%) and T cell were 5(83.3%) (P=0.464). None of the patient had partial response or induction failure. Complication were developed in 53(60.91%) patients during induction therapy. Most common cause of death was septicemia (22/26). Death was more in patients who had total WBC count >50X109/L (p=0.017) and received regimen B (p=0.031).
 Conclusion: B cell ALL was more common and most of the patients had undergone complete remission after induction remission therapy.
 Journal of Current and Advance Medical Research, January 2021;8(1):59-64

Experience of Paediatric Acute Lymphoblastic Leukemia Service in A Newly Established Haemato-Oncology Center in Bangladesh: Opportunities and Challenges

“…In our study, 1 child (8%) had T cell lineage and 92% patient was B cell lineage which is comparable to another Bangladeshi study where among 87 analyzed patients, 93.1% were B-cell ALL and 6.9% were Tcell ALL. 18 In our study the highest WBC count t50,000/ mm 3 was 42%. These counts were higher when compared to studies in the west but in concordance with studies from other Low-and Middle-income countries (LMIC), where baseline white blood cell (WBC) count of >50,000/mm 3 was seen in 23-37%.…”

“…Diba F et al found in her study that most of the patients were 1 to 9 years of age (87.4%), which is almost similar to our study. 18 Sampagar A et al reported that male to female ratio of newly diagnosed ALL was 1.15:1. 19 In our study male to female ratio of newly diagnosed ALL was 1:1.…”

Outcomes of childhood acute lymphoblastic leukemia treated with the modified St Jude Total Therapy XV Protocol: a single-center experience in Turkey

“…Diba et al published their ALL study in Bangladesh (lower middle income -WB) involving 87 children aged 1-18 years that the cumulative mortality was found to be 29.9%, and the primary cause of death (22/26, 84.6%) was septicemia. [30] Infection is not just a problem of LICs. Although the mortality rate is low when examined in HIC, infection, and septicemia are still the number one cause among the causes of TRD.…”