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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.
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.
Approximately 90% of confirmed cancer cases annually are reported in low to middleincome countries. In Honduras, the incidence of pediatric cancer has been steadily increasing, accompanied by a higher cancer mortality rate attributed to diagnostic errors, limited access to healthcare, and management challenges. Diagnostic pitfalls, such as failure to recognize signs of malignancy, inadequate assessment of persistent symptoms, and misinterpretation of diagnostic tests, significantly impede effective cancer care. This retrospective case study collected data from 68 pediatric patients diagnosed with Acute Lymphoblastic Leukemia (ALL) at the Honduran Social Security Institute in Tegucigalpa between January 2015 and December 2022. Data retrieval encompassed demographic features, clinical characteristics, and laboratory findings. We used SPSS Statistics version 29.0.2.0 to perform all statistical analysis. The cohort comprised patients of equal gender distribution, with 42.6% (N: 29) belonging to the age group of 1 to 4 years. The hospital diagnosed an average of 8.5 cases each year. Fever was the most prevalent symptom, affecting 80.9% of patients (N: 55). Hemoglobin levels were below 10 mg/dL in 67.6% of patients, with 33.8% exhibiting levels below 7 mg/dL (N: 23) and equal proportion falling within the 7-10 mg/dL range (N: 23). Platelet levels were below 150,000/μL, with 48.5% experiencing severe thrombocytopenia (platelet levels <50,000/μL). Additionally, most patients presented phosphorus levels exceeding 4.5 mg/dl (N: 33, 48.5%), along with elevated LDH levels surpassing 500 U/l (N: 34, P: 50%). The presence of persistent fever should trigger suspicion of cancer, necessitating thorough assessment. Implementing guidelines outlining common symptoms and referral protocols could significantly reduce mortality in Honduran children with ALL.
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