Características clínicas-epidemiológicas de niños con leucemia aguda de 0 a 15 años atendidos en el Instituto Nacional de salud del Niño del periodo 2005-2010 / Clinical and epidemiological characteristics of children with acute leukemia from 0 to 15 years treated at the National Institute of Child Health 2005-2010

Introducción: La incidencia de leucemia aguda en el Perú es de 1500 casos nuevos al año, de los cuales el 30 por ciento se presenta en pacientes pediátricos. La características clínicas-epidemiológicas son muy importantes como factores de riesgo, dándonos un pronóstico de evolución de la enfermedad. Objetivo: Describir las características clínicas-epidemiológicas de niños con Leucemia Aguda entre 0 a 15 años atendidos en el lNSN, periodo 2005-2010. Materiales y métodos: De 300 historias clínicas, se revisó 111 historias clínicas que cumplían con los criterios de inclusión, recolectamos los datos considerados como factores de riesgo elevado y las manifestaciones clínicas de ingreso. Resultados: El 46,8 por ciento fue diagnosticado de Leucemia Linfoblástica Aguda (LLA), 44,1 por ciento como Leucemia Aguda (LA) y 9 por ciento como Leucemia Mieloide Aguda (LMA). Entre los factores de riesgo elevados, el sexo que predominó fue el masculino de 1.6: 1, se notó que el 26.1 por ciento tenían un edad de 10 años a más, el 85.6 por ciento de los pacientes cursaron con el recuento leucocitario por debajo de 50, 000 células por mm3,el 62.2 por ciento presentó visceromegalia y el 63.1 por ciento adenomegalia .La manifestación clínica más frecuente fue fiebre en un 67.6 por ciento generalmente asociado a otro síntoma como diarrea, tos productiva, etc. Otros signos de ingreso frecuentes fueron palidez (57.7 por ciento) y síndrome hemorrágico (42.3 por ciento)...

Introduction: Acute Leukemia represents 30 per cent of all childhood cancers, with an incidence of 1,500 in Peru and a third of all of these affects the pediatric population. The clinical and epidemiological characteristics are very important in order to identify risk factors and to give a prognosis of the disease' outcome. Objective: To describe the clinical and epidemiological characteristics of Acute Leukemia in children between O to 15 years old who were treated in INSN, in 2007-2010. Materials and Methods: We colleded data from 111 clinical records of children with diagnosed Acute Leukemia that reached all the discemment criteria, considering risk factors and clinical manifestations in the time of admission. Results: 46,8 per cent were diagnosed with ALL, 44,1 per cent with AL and per cent with AML. In the risk factors there was a predominance by male patients of 1.6:1, patients were mostly over 10 years old, the leukocyte counts were found to be mostly under 50,000 cells in mm³, over 60 per cent presented an increased size of the spleen, Iiver and certain Iymph nodes. The most common clinical manifestation at the time of the diagnosis was fever (67.6 per cent), usually related to other symptoms such as diarrhea, cough and others. Other frecuent clinical manifestations were paleness (57.7 per cent) and hemorrhagic syndrome (42.3 per cent). A eight at the time of birth greater than 3500 grams was related to leukemia in the 50 per cent of the reviewed cases. The number of cases of leukemia in first-bom was 28.3 per cent...

Clinico-hematological profile in biphenotypic acute leukemia.

BACKGROUND: We present a clinico-hematological profile and treatment outcome of Biphenotypic Acute Leukemia (BAL). AIM: Study incidence and subtypes of BAL, correlate with age, morphology, and cytogenetic findings and correlate the clinico-hematological data with the treatment response. St Jude's and the EGIL's criteria have been compared for their diagnostic and clinical relevance. MATERIAL AND METHODS: Diagnosis was based on WHO classification, including clinical details, morphology, cytochemistry, immunophenotyping, and molecular genetics. We included those cases, which fulfilled the European Group for the Immunological Characterization of Acute Leukemia's (EGIL's) scoring system criteria for the diagnosis of BAL, as per recommendation of the WHO classification. RESULTS: There were 32 patients diagnosed with BAL, based on EGIL's criteria. Incidence of BAL was 1.2%. B-Myeloid (14 cases) followed by T-Myeloid BAL (13 cases) were the commonest subtypes. Polymorphous population of blasts (16 cases) was commonly associated with T-Myeloid BAL (10 cases). BCR ABL fusion positivity was a common cytogenetic abnormality (seven cases). Fifteen patients received chemotherapy; eight achieved complete remission (CR) at the end of the induction period. CONCLUSIONS: Pediatric BAL and T-B lymphoid BAL have a better prognosis. A comprehensive panel of reagents is required, including cytoplasmic markers; to diagnose BAL. St Jude's criteria is a simple, easy, and cost-effective method to diagnose BAL. The outcome-related prognostic factors include age, HLA-DR, CD34 negativity, and subtype of BAL. BCR-ABL expression is an important prognostic factor, as these cases will be labeled as Chronic myeloid leukemia (CML) in blast crisis with biphenotypic expression and treated accordingly.