Authors :
Dr. Santosh Suman; Dr. Sangeeta Pahuja; Dr. Shailaja Shukla; Dr. Sunita Sharma; Dr. Jagdish Chandra; Dr. Alice Xalxo
Volume/Issue :
Volume 9 - 2024, Issue 7 - July
Google Scholar :
https://tinyurl.com/bdfc3h65
Scribd :
https://tinyurl.com/29ms6cty
DOI :
https://doi.org/10.38124/ijisrt/IJISRT24JUL1647
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Background:
Pediatric B-cell Acute Lymphoblastic Leukemia
presents with diverse clinical and hematological
manifestations. Understanding these characteristics is
crucial for effective management and prognostication.
Methods:
This study conducted as prospective observational
study at Lady Hardinge Medical College and Kalawati
Saran Children Hospital, New Delhi, from November
2017 to March 2019. This study enrolled 30 pediatric
patients with B-cell ALL who underwent comprehensive
evaluations including routine and specialized
hematological tests, bone marrow aspiration (BMA),
cytochemistry, and immunophenotyping. Clinical
features, hematological parameters, and CD66c
expression on lymphoblasts were assessed.
Results:
Immunophenotyping revealed that 28 cases (93.3%)
were CALLA positive (CD10 positive), while 2 cases
(6.7%) were CALLA negative (CD10 negative). The age
ranged from 1.5 to 12 years, with a 2:1 male to female
ratio. The mean age was 4.8 years.. Common presenting
complaints included fever (93.3%) and pallor (60.0%).
Hepato-splenomegaly (60.0%) and lymphadenopathy
(60.0%) were the most frequent clinical findings.
Hematological findings showed moderate to severe
anemia (mean hemoglobin 7.19 g/dL), with 56.7% of
patients having hemoglobin levels between 4.0-7.9 g/dL.
Leukocytosis (>10,000/cumm) was observed in 53.3% of
cases, with 20% having total leukocyte counts
>50,000/cumm. Thrombocytopenia (platelet count ≤
25,000/cumm) was noted in 56.7% of patients.
Immunophenotyping revealed CD66c expression >20%
gated in 46.7% of cases, correlating with more severe
clinical features and poorer hematological parameters.
Conclusion:
Pediatric B-cell ALL exhibits a spectrum of clinical
and hematological features. Elevated CD66c expression
correlates with aggressive disease presentation and worse
clinical outcomes, suggesting its potential utility as a
prognostic marker. Early identification of these
parameters can aid in risk stratification and tailored
therapeutic approaches.
Keywords :
Pediatric Leukemia, B-Cell ALL, CD66c Expression, Clinical Features, Hematological Parameters.
References :
- Sethy S, Sahoo SS, Jena RK, Das S,. Clinico-Haematological Profile of patients with Mixed Phenotype Acute Leukemia: In a Tertiary Care Centre.
- Khan F, Malik HS, Bozdar M, Mahmood R,. Clinico-haematological Profile and Post-Induction Remission Status of Newly Diagnosed Paediatric Acute Lymphoblastic Leukaemia Patients with ETV6:: RUNX1 Gene Rearrangement. Journal of Haematology and Stem Cell Research. 2023;3(2):68-73.
- Rushin Patel et al; Glob Acad J Med Sci; Vol-6, Iss-2 (Mar-Apr, 2024): 83-97
- Meena R, Nangia A, Sharma S, Chandra J. Serum levels of vascular endothelial growth factor and its receptor in newly diagnosed paediatric acute lymphoblastic leukemia. Indian Journal of Hematology and Blood Transfusion. 2021 Oct;37(4):586-92.
- Onoja AM, Otene SA, Onoja AT, Ibrahim IN,. Prevalence and nature of adult hematological malignancies using bone marrow aspiration cytology in a tertiary health facility: a seven year retrospective review. Western Journal of Medical and Biomedical Sciences. 2021 Apr 12;2(1):43-9.
- El Achi H, Dupont E, Paul S, Khoury JD. CD123 as a biomarker in hematolymphoid malignancies: principles of detection and targeted therapies. Cancers. 2020 Oct 23;12(11):3087
- Menon H, Singh PK, Bagal B, Dolai T,. Minimal Residual Disease in the Management of B-Cell Acute Lymphoblastic Leukemia: A Systematic Review of Studies from Indian Settings. Indian Journal of Hematology and Blood Transfusion. 2024 Jan;40(1):1-1.
- Li W. Measurable Residual Disease Testing in Acute Leukemia: Technology and Clinical Significance. Exon Publications. 2022 Oct 16:79-100.
- Kárai B, Tisza K, Eperjesi O, Nagy AC,. A Novel Method for the Evaluation of Bone Marrow Samples from Patients with Pediatric B-Cell Acute Lymphoblastic Leukemia—Multidimensional Flow Cytometry. Cancers. 2021 Oct 9;13(20):5044.
- Kulis J, Wawrowski Ł, Sędek Ł, Wróbel Ł. Machine learning based analysis of relations between antigen expression and genetic aberrations in childhood B-cell precursor acute lymphoblastic leukaemia. Journal of Clinical Medicine. 2022 Apr 19;11(9):2281.
- Pierzyna-Świtała M, Sędek Ł, Kulis J,. Multicolor flow cytometry immunophenotyping and characterization of aneuploidy in pediatric B-cell precursor acute lymphoblastic leukemia. Central European Journal of Immunology. 2021 Jul 1;46(3):365-74.
Background:
Pediatric B-cell Acute Lymphoblastic Leukemia
presents with diverse clinical and hematological
manifestations. Understanding these characteristics is
crucial for effective management and prognostication.
Methods:
This study conducted as prospective observational
study at Lady Hardinge Medical College and Kalawati
Saran Children Hospital, New Delhi, from November
2017 to March 2019. This study enrolled 30 pediatric
patients with B-cell ALL who underwent comprehensive
evaluations including routine and specialized
hematological tests, bone marrow aspiration (BMA),
cytochemistry, and immunophenotyping. Clinical
features, hematological parameters, and CD66c
expression on lymphoblasts were assessed.
Results:
Immunophenotyping revealed that 28 cases (93.3%)
were CALLA positive (CD10 positive), while 2 cases
(6.7%) were CALLA negative (CD10 negative). The age
ranged from 1.5 to 12 years, with a 2:1 male to female
ratio. The mean age was 4.8 years.. Common presenting
complaints included fever (93.3%) and pallor (60.0%).
Hepato-splenomegaly (60.0%) and lymphadenopathy
(60.0%) were the most frequent clinical findings.
Hematological findings showed moderate to severe
anemia (mean hemoglobin 7.19 g/dL), with 56.7% of
patients having hemoglobin levels between 4.0-7.9 g/dL.
Leukocytosis (>10,000/cumm) was observed in 53.3% of
cases, with 20% having total leukocyte counts
>50,000/cumm. Thrombocytopenia (platelet count ≤
25,000/cumm) was noted in 56.7% of patients.
Immunophenotyping revealed CD66c expression >20%
gated in 46.7% of cases, correlating with more severe
clinical features and poorer hematological parameters.
Conclusion:
Pediatric B-cell ALL exhibits a spectrum of clinical
and hematological features. Elevated CD66c expression
correlates with aggressive disease presentation and worse
clinical outcomes, suggesting its potential utility as a
prognostic marker. Early identification of these
parameters can aid in risk stratification and tailored
therapeutic approaches.
Keywords :
Pediatric Leukemia, B-Cell ALL, CD66c Expression, Clinical Features, Hematological Parameters.