Acute Lymphoblastic Leukaemia: Clinicohaematological Features, Laboratory Characteristics and Prognostic Factors: a Single Center Experience

ABSTRACT

To study clinico-haematological features, Laboratory results and prognostic factors in patients of acute lymphoblastic leukaemia. Descriptive study. This study included all newly diagnosed cases of acute lymphoblastic Leukaemia coming to Armed Forces Institute of Pathology Rawalpindi from Jun 2008-Feb2010. The detailed clinical history with physical findings were charted on the proforma. About 3ml blood from each patient was taken in EDTA container. The blood was analyzed on Haematology analyzer Sysmex KX 21. Quality control was maintained by running normal and abnormal controls. Bone marrow aspiration was done at the time of diagnosis. Five push smears were made from each case; 2 for leishman stain, one for Sudan black B, one for periodic cid schiff, and one for acid phosphatase. The common clinical features in children were pallor [100%], fever [93%], hepatomegaly [70%], splenomegaly [64%], lymphadenopathy [58%], bleeding manifestations [27%] and bone pain [9%]. Pallor [100%] and fever [89%] were also common manifestations in adults. Initial high white cell count [> 50x109/l] was observed in 9 [12%] patients. Three patients showed hyperleucocytosis [> 100x109/l]. Haemoglobin < 8gm/dl was seen in 30 11%] patients and platelet count less than 20x109/l was observed in 8 [10.8%] cases. About 9 [12%] patients showed pancytopenia. According to French-American-British [FAB] criteria ALL-L1 was the commonest FAB type [81%], followed by L2 [16%] and L3 [3%] in children while ALL L2 was high among adult age group. We found that ALL is a frequent childhood hematological malignancy in our setting and is more prevalent in males both in children and adults. ALL- L I type being more common than other types of ALL. Considering the prognostic factors of age, WBC count, lymphadenopathy, T immunophenotyping an FAB classification; most of our patients constitute a better prognostic group