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Pancytopenia - (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia.

Raja S, Suman FR, Scott JX, Latha MS, Rajenderan A, Ethican A - South Asian J Cancer (2015 Apr-Jun)

Bottom Line: Though cytogenetic abnormalities are more common in pancytopenic group, it is not statistically significant (P = 0.106).There is no significant difference in treatment outcome between the groups (P = 0.0827%).There is no significant difference in the outcome between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Paediatric Haematology Oncology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.

ABSTRACT

Context: Acute lymphoblastic leukemia (ALL) ranks first among pediatric malignancies. 8-12% of ALL present with pancytopenia and 2% with hypocellular marrow a. Diagnosis of ALL in the background of pancytopenia and aplastic bone marrow is difficult.

Aims: This study was aimed to compare the clinicopathologic, genetic, and outcome of paediatric ALL patients with and without pancytopenia.

Settings and design: This is a retrospective cross-sectional study.

Subjects and methods: The study included all ALL patients presenting with pancytopenia. The control group included equal number of randomly selected patients with ALL without pancytopenia treated during the same period. Ethics committee approved this study. The demographic, laboratory, and treatment-related details were retrieved from the records and entered in an Excel sheet.

Statistical analysis used: Data was analyzed with Chi-square test with IBM SPSS statistics 16 software.

Results: Diagnosis by peripheral smear is significantly lower (P = 0.015) in comparison with the control group. There is no significant difference in diagnosis between the groups by bone marrow aspirate (P = 0.731) and biopsy (P = 0.849). The diagnosis of leukemia is misdiagnosed as hypo cellular/aplastic marrow in 10% of the pancytopenic patients. Flow cytometry yielded the diagnosis in all the pancytopenic patients. Though cytogenetic abnormalities are more common in pancytopenic group, it is not statistically significant (P = 0.106). There is no significant difference in treatment outcome between the groups (P = 0.0827%).

Conclusions: Clinical expertise is highly essential to evaluate a case of pancytopenia to diagnose leukemia. Pancytopenia is an obstacle in the diagnosis of ALL without immunophenotyping. There is no significant difference in the outcome between the two groups.

No MeSH data available.


Related in: MedlinePlus

Kaplan Meier survival plot
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Figure 1: Kaplan Meier survival plot

Mentions: The outcome of the patients till the follow-up period when compared showed no significant difference between the two groups. The median duration of follow-up is 25.23 ± 15.36 months and 23.95 ± 13.99 months in patients with pancytopenia and without respectively without significant difference. The overall survival, death rate and current status of the patients are shown in Figure 1, Tables 3 and 4, respectively.


Pancytopenia - (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia.

Raja S, Suman FR, Scott JX, Latha MS, Rajenderan A, Ethican A - South Asian J Cancer (2015 Apr-Jun)

Kaplan Meier survival plot
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4418085&req=5

Figure 1: Kaplan Meier survival plot
Mentions: The outcome of the patients till the follow-up period when compared showed no significant difference between the two groups. The median duration of follow-up is 25.23 ± 15.36 months and 23.95 ± 13.99 months in patients with pancytopenia and without respectively without significant difference. The overall survival, death rate and current status of the patients are shown in Figure 1, Tables 3 and 4, respectively.

Bottom Line: Though cytogenetic abnormalities are more common in pancytopenic group, it is not statistically significant (P = 0.106).There is no significant difference in treatment outcome between the groups (P = 0.0827%).There is no significant difference in the outcome between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Paediatric Haematology Oncology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.

ABSTRACT

Context: Acute lymphoblastic leukemia (ALL) ranks first among pediatric malignancies. 8-12% of ALL present with pancytopenia and 2% with hypocellular marrow a. Diagnosis of ALL in the background of pancytopenia and aplastic bone marrow is difficult.

Aims: This study was aimed to compare the clinicopathologic, genetic, and outcome of paediatric ALL patients with and without pancytopenia.

Settings and design: This is a retrospective cross-sectional study.

Subjects and methods: The study included all ALL patients presenting with pancytopenia. The control group included equal number of randomly selected patients with ALL without pancytopenia treated during the same period. Ethics committee approved this study. The demographic, laboratory, and treatment-related details were retrieved from the records and entered in an Excel sheet.

Statistical analysis used: Data was analyzed with Chi-square test with IBM SPSS statistics 16 software.

Results: Diagnosis by peripheral smear is significantly lower (P = 0.015) in comparison with the control group. There is no significant difference in diagnosis between the groups by bone marrow aspirate (P = 0.731) and biopsy (P = 0.849). The diagnosis of leukemia is misdiagnosed as hypo cellular/aplastic marrow in 10% of the pancytopenic patients. Flow cytometry yielded the diagnosis in all the pancytopenic patients. Though cytogenetic abnormalities are more common in pancytopenic group, it is not statistically significant (P = 0.106). There is no significant difference in treatment outcome between the groups (P = 0.0827%).

Conclusions: Clinical expertise is highly essential to evaluate a case of pancytopenia to diagnose leukemia. Pancytopenia is an obstacle in the diagnosis of ALL without immunophenotyping. There is no significant difference in the outcome between the two groups.

No MeSH data available.


Related in: MedlinePlus