Epidemiological Study of Clinical and Laboratory Profiles of Patients with Acute Lymphoblastic Leukemia at Dr. Soetomo Hospital Surabaya

Abstract

Introduction: Considering the high number of acute lymphoblastic leukemia (ALL) and it being the type of cancer with the highest fatality rate among the children, this study seeks to determine the epidemiological description of the clinical and laboratory profiles of patients with ALL.Methods: This research used a descriptive study by using medical data record of patients with ALL. The research variables were gender, age, leukemia history of the patient’s family, nutritional status, symptoms and signs, laboratory examination, ALL subtypes, risk factors, and result outcomes. All data presented descriptively.Results: From a total of 50 patients, 54 % of them were male aged 1,5 – 10 years old. 84% of the patients’ family had no medical record related to leukemia. 42% of the patient malnutrition. Pale (78%), fever (64%), pain (32%), hepatomegaly (38%), lymphadenopathy (28%), splenomegaly (26%), patients with anemia (82%), leukocytosis (38%), thrombocytopenia (54%). The highest types were ALL–LI (68%), SR-ALL (54%), and remission outcome reached 82%.Conclusion: Insidence higher in male, aged 1,5 – 10 years old, malnourished at the start of the diagnosis. Most of the patients’ family had no medical history of leukemia. Symptoms and medical signs mostly appeared were pale, fever, and bone/joint pain. The physical examination showed hepatomegaly, lymphadenopathy, and splenomegaly and laboratory first test showed the patients had anemia, leukocytosis, and thrombocytopenia.

Characteristics of patients with acute lymphoblastic leukemia in 2016-2020 at Sanglah General Hospital, Bali

“…In a previous study by Putri et al, from 50 ALL patients, 33 patients (66%) had hemoglobin level of 5 -10 g/dL. 5 Another study by Tarigan et al showed 40 patients (48%) had hemoglobin level <7.0 g/dL. 6 Anemia in ALL caused by loss of bone marrow hematopoietic function due to progressive infiltration of malignant leukemia cells.…”

“…6 Anemia in ALL caused by loss of bone marrow hematopoietic function due to progressive infiltration of malignant leukemia cells. 5 Leukocyte count in ALL can be found increased, normal, or decreased. 6 In our study, most children and adults showed an increase in leukocyte count (leukocytosis).…”

“…5, 18 Thrombocytopenia can occur as one of the hematopoietic dysfunction results. 5 The result of the bone marrow aspiration (BMA) examination, based on the FAB classification (Table 3), showed that the most common morphology of ALL was L2 subtype/ALL-L2 (78.9%). Similarly, Tarigan et al, from 84 patients with ALL, 61 patients (72%) was L2 subtype.…”

“…The National Cancer Institute estimates that in 2018 as many as 60,300 people were living with ALL, and about 1,440 deaths from this disease. 5 ALL has a high incidence rate and is the most common cause of death in children. 6 However, not much data have been reported about the characteristics of patients with ALL.…”