Clinical, hematological, and laboratory presentation of acute lymphoblastic leukemia of children in Diyala province/Eastern Iraq

Abstract

Background: To show the initial presenting features the children of acute lymphoblastic leukemia presented till the diagnosis at oncology Center/ Diyala/ Iraq.Methods: A retrospective study, carried out during 2016-2017. The data include constitutional, hematological, and infiltrative features with laboratory findings registered at patient’s files until the diagnosis. Data were analyzed by Statistical Package of Social Sciences v. 20.Results: The total patients were 55, distributed into: T- cell (10.9%) and B- cell leukemia (89.1%), FAB classification include L1 (11%), L 2 (89%) and L3 (0%). Most of patients presented at 1- 10 years of age (p value= 0.000); M: F= 1.3:1 (p value= 0.345). Fever and pallor were the most common features, 81.8% (p value=0.000) and 67.3% (p value=0.010), respectively. Other features were bone pain (40%), anorexia (36.4%), fatigability (30.9%), muco-cutaneous bleeding (27.3%), hepatosplenomegaly (56.4%), lymphadenopathy (49.1%), and facial palsy (1.8%). Hemoglobin was < 8 gm/ dl in 70.9 %, white cell count was < 50×109 cells/L in 70.9 %; 12.3% has severe leukocytosis, and platelets' count was between 20- 100 × 109 cells/L in 49%. Mediastinal infiltration (7.2%), pleural effusion (1.8%), pericardial effusion (1.8%), and positive cytospin (5.4%).Conclusions: L2 subtype was the dominant subtype; this contrary to all other studies and may be related to the prognosis. Most of the initial features were general and may indicate more common illnesses, but their constellation with complete blood picture should rise the possibility of leukemia. A rare complication, pleural effusion, was detected as initial feature.

Association of Parental, Child, and Environmental Factors with the Occurrence of Childhood Leukemia in Upper Egypt

“…A retrospective Iraqi study reported the initial presenting features of childhood leukemia were fever (81.8%), pallor (67.3%), hepatosplenomegaly (56.4%), lymphadenopathy (49.1%), bone pain (40%), anorexia (36.4%), and mucocutaneous bleeding (27.3%). (36) Reports vary on the relationship of residence with childhood leukemia. Our study showed that residence was not a risk factor for childhood leukemia.…”

Clinical and Laboratory Manifestation of Children with Acute Lymphoblastic Leukemia as an Assessment of Severity: A Study in Dr. Hasan Sadikin General Hospital

“…Similarly found in Eastern Iraq and India, where the most dominant type was L2, followed by L1 and L3. 12,18 The limitation of this study was inaccessible medical record data or incomplete data which caused data to be excluded, resulting in a lower sample population.…”

“…This is consistent with findings from previous studies that fever, pallor, and hepatosplenomegaly are the main presenting complaints of ALL. 12,13 In addition to their infiltration to bone marrow, leukemic cells also infiltrate other organs. Spleen, liver, and lymph nodes are the most common infiltrated organs.…”

“…These findings are similar to other reports where a large proportion of ALL patients are classified for having severe anemia. 12,15 Leukocytosis is commonly presented in ALL patients. Similarly to the findings in Iran and Brazil, where most patients have leukocytosis.…”

Efficacy of acupressure on nausea and vomiting among children with leukemia following chemotherapy

“…In developed countries, leukemia accounts for 30% of all cancers among children below 15 years of age, and is considered the most common childhood malignancy, where acute lymphoblastic leukemia (ALL) is the most predominant type representing 80% of all cases of leukemia. [1,2] Despite being a global public health problem, in developing countries the image of leukemia in children is different from that in developed countries, where its incidence is increasing with variations in survival rates and in methods and time of diagnosis. Genetic and environmental risk factors and differences in diagnosis and treatment may play major role in this variation.…”