Clinical profile and short-term outcome of pediatric hyperleukocytic acute leukemia from a developing country

ABSTRACT

This study was conducted to determine the frequency, clinical profile, and short-term outcome of children with hyperleukocytosis at two pediatric oncology centers in Karachi. Of a total 1,045 patients, 13.97% [n=146] patients had hyperleukocytosis. Majority [61.7%, n=90] were under 10 years of age and 76% [n=146] were male. The symptom duration before diagnosis was more than 30 days in 49.3% [n=72]. The median WBC count was 181 x109/L [IQR=130.45- 298.3] and extreme hyperleukocytosis [>200 x109/L] was observed in 44.5% [n=65] patients. Majority [94.5%, n=138] of patients were diagnosed with acute lymphoblastic leukemia. One or more complications developed in 78% [n=114] of cases. Clinical and laboratory tumor lysis syndrome [TLS] was observed in 17.1% [n=25] and 39% [n=57] patients, respectively. Pulmonary and neurological complications related to leukostasis were noted in 9.5% [n=14] and 27.3% [n=40] of cases, respectively. Infectious complications occurred in 23.2% [n=34] patients. The case-specific mortality was 20.5% [n=30]. No mortality was related to early complications of hyperleukocytosis