Relapses in childhood acute lymphoblastic leukaemia

The study included [264] children with All diagnosed and treated at the oncology unit of Al-Mansoor children Hospital were reviewed over the period from January 1989 to January 1994, to study relapses in childhood All. Of the [211] eligible patients, 44 [20.8%] had relapse, and those with initial W.B.C. count > 50 109/l had higher rate of relapse. Bone marrow is found to be the most common site for relapse [68.2%], followed by CNS [20.4%], combined sites [9.1%] and then testicular relapse [2.3%]. The study showed no significant correlation between the type of CNS directed treatment and the development of CNS relapse. The effect of economic sanction is evident by cumulative higher rate of relapse and death

Neurological manifestations of acute leukaemia in children

Neurologic manifestations of leukaemia are due to leukaemic infiltration of meninges, brain and cranial or peripheral nerves or result from intracranial hemorrhage and infection. This complication has been noted in 18 out of 176 patients with acute leukaemia whether they are newly diagnosed or previously diagnosed [i.e. on maintenance therapy] admitted to Al-Mansoor Pediatric teaching hospital from the first of Nov. 1992 to thirty-first of March 1993. The symptomatology of [CNS] involvement consist of vomiting headache, convulsions, cranial nerve palsy and non-specific neuro1ogica1 signs. It is more predominant in males than females; it may occur at any stage of the disease, as initial manifestation or during hematological remission or an active leukaemic phase. 3 of our patients presented as initial manifestation, 7 were in haematological remission. The spinal fluid demonstrated increased cell count, elevated protein concentration and decreased sugar level. The incidence, of CNS leukaemia is inversely correlated with platelets count at the time of initial diagnosis of leukaemia and directly related with total leucocytec count