Clinical and Laboratory Manifestation of Children with Acute Lymphoblastic Leukemia as an Assessment of Severity: A Study in Dr. Hasan Sadikin General Hospital
Abstract
Background: Acute lymphoblastic leukemia (ALL) is a disease caused by a mutation of lymphoid progenitor cells in bone marrow, that induces uncontrolled lymphoid cell proliferation. ALL is the most common type of leukemia in children. Various clinical and laboratory manifestation makes the diagnostic process more complicated. This study aimed to observe the clinical and laboratory manifestation of children with ALL in Dr. Hasan Sadikin General Hospital for diagnostic and assessment.
Methods: The design of this study was a descriptive cross-sectional with a total sampling method. Data of all children under 18 years old with ALL diagnosed in 2015 to 2017 were included. The diagnosis of ALL was confirmed by examination of hematology indices, peripheral blood smear, and bone marrow aspiration classified by FAB. Inaccessible or incomplete medical records were excluded.
Results: In total, 192 data of ALL patients were included. Most ALL patients predominantly occurred in boys (59.9%), and the age group of 1–5 years old (40.6%). The clinical manifestations were pallor (89.6%), hepatomegaly (79.7%) and fever (75%). Most patients experienced severe anemia with hemoglobin level <7g/dL (44.8%), leukocytosis >20.000 cells/mm3 (46.9%), severe thrombocytopenia with platelet count <20.000 cells/mm3 (51%), and blast cells count >50% (45.3%). Based on FAB classification, the majority of the patients were classified as ALL type L2 (65.6%).
Conclusions: Clinical and laboratory manifestation of ALL patients can be used as a parameter for diagnostic and assessment of severity. Earlier diagnosis would result in better prognosis and more precise treatment for ALL patients.
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Kliegman RM, Stanton BF, Schor NF, St Geme III JW, Behrman RE. Nelson textbook of pediatrics. 19th ed. Elsevier. Philadelphia: Elsevier Saunders; 2011.
Starý J, Hrušák O. Recent advances in the management of pediatric acute lymphoblastic leukemia. F1000Research. 2016;5(0).
Ward E, Desantis C, Robbins A, Kohler B, Jemal A. Childhood and Adolescent Cancer Statistics. CA: A Cancer Journal for Clinicians. 2014;64.
Roganovic J. Acute lymphoblastic leukemia in children. InTech Open. 2013;39–74.
Suryawan N, Idjradinata P, Reniarti L. Hubungan subtipe sel limfosit dengan tingkat remisi pascakemoterapi fase induksi leukemia limfoblastik akut. Sari Pediatri. 2017;18(6):448–52.
Inten Y, Reniarti L, Chairulfatah A, Inten Y, Reniarti L, Chairulfatah A. Hubungan kadar procalcitonin dengan demam neutropenia pada leukemia limfoblastik akut anak. Sari Pediatri. 2015;17(38):267–72.
Tehuteru ES dr. Buletin Kanker (Mewaspadai Gejala Kanker pada Anak). Pusat Data dan Informasi Kementerian Kesehatan RI. Jakarta; 2015.
Tanzilia MF, Cahyadi A, Hernaningsih Y, Retnowati E, Ugrasena IDG. CD4+ T-cell, CD8+ T-cell, CD4+/CD8+ ratio, and apoptosis as a response to induction phase chemotherapy in pediatric acute lymphoblastic leukemia. Paediatrica Indonesiana Journal. 2017;57(6):138–43.
Abdul-hamid G. Classification of acute leukemia, acute leukemia - The scientist’s perspective and challenge. InTech. 2011;
Barrington-Trimis JL, Cockburn M, Metayer C, Gauderman WJ, Wiemels J, McKean-Cowdin R. Trends in childhood leukemia incidence over two decades from 1992-2013. International Journal of Cancer. 2015;162(3):561–7.
Li S, Ye J, Meng F, Li C, Yang M. Clinical characteristics of acute lymphoblastic leukemia in male and female patients: A retrospective analysis of 705 patients. Oncol Letters. 2015;453–8.
Shalal HH, Mahmood NS, Abdul M, Alchalabi Q. Clinical , hematological , and laboratory presentation of acute lymphoblastic leukemia of children in Diyala province / Eastern Iraq. International Journal of Research in Medical Sciences. 2017;5(10):4227–33.
Omari AS Al, Hussein TA, Albarrak KA, Habib AK, Sambas AA, Sheblaq N, et al. Clinical characteristics and outcomes of acute lymphoblastic leukaemia in children treated at a Single Tertiary Hospital in Riyadh , Saudi Arabia. Journal of Health Specialties. 2018;14–8.
Pahloosye A, Hashemi A. Presenting clinical and laboratory data of childhood Acute lymphoblastic leukemia. Iranian Journal of Pediatric Hematology Oncology. 2011;1(3):71–7.
Lustosa de Sousa DW, de Almeida Ferreira FV, Cavalcante Félix FH, de Oliveira Lopes MV. Acute lymphoblastic leukemia in children and adolescents: Prognostic factors and analysis of survival. Revista Brasileira de Hematologia Hemoterapia. 2015;37(4):223–9.
Ibagy A, Silva DB, Seiben J, Winneshoffer a P, Costa TE, Dacoregio JS, et al. Acute lymphoblastic leukemia in infants: 20 years of experience. Jornal de Pediatria (Rio J). 2013;89(1):64–9.
Ya K, Liana P, Indriani B, Klinik BP, Kedokteran F, Rsmh US. Pola Gambaran darah tepi pada penderita leukimia di Laboratorium Klinik RSUP Dr . Mohammad Hoesin Palembang. Majalah Kedokteran Sriwijaya. 2014;(4):259–65.
Singh G, Parmar P, Kataria SP, Singh S, Sen R. Spectrum of acute and chronic leukemia at a tertiary care hospital , Harayana, India. International Journal of Research in Medical Sciences. 2016;4(4):1115–8.
DOI: https://doi.org/10.15850/amj.v6n2.1528
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