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Abstract

IMPLICATIONS PROGNOSTIC OF CLINICOPATHOLOGIC FEATURES IN ACUTE LEUKEMIA

Walaa Fikry Elbossaty*, Camelia A. A. Malak, Doaa M. Elghanam

ABSTRACT

Introduction: Acute leukemia is the most common malignancy in children of which acute Lymphoblastic leukemia accounts for majority of the cases. Aims: The objective of this study was to investigate the clinical profile, hematological parameters, and laboratory parameters in acute leukemia. Materials and Methods: Leukemia was suspected in patients presenting with history of prolonged fever, pallor, hepatosplenomegaly, Lympadenopathy, abnormal bleeding or history of repeated blood transfusion. A complete history, clinical examination and relevant investigations were done to diagnose leukemia. After confirmation of diagnosis, patients were treated, followed up to first remission after receiving chemotherapy. Follow up bone marrow examination was done after induction phase to confirm remission. Peripheral blood and bone marrow were tested for surface membrane, cytoplasmic and nuclear antigens and were classified by the French-American- British (FAB) Cooperative Group. Results: Out of total 50 patients, 18 (36%) were ALL and 32 (64%) were AML. Out of 50 patients, 34 (68%) patients were male while 16 (32%) were female. Age ranged from 17 to 66 years (median 41.58 years). Chief complaints at presentation were fever (78%), Pallor (72%), and fatigue (60%), weight loss (50%). Clinical signs at presentation included Splenomegaly (86%), Hepatomegly (86%) and Lympadenopathy (52%). Forty two patients (74.2%) presented with moderate anemia. Remission was achieved in 44 cases (88%) after chemotherapy. Hemoglobin, Total WBC count, Platelet counts, Lactate dehydrogenase levels and abnormal karyotypes were detected in acute leukemia. Conclusion: We assessed the role of clinicopathological with various hematological and biochemical parameters and in our study, AML is more common than ALL in adult. ML tended to appear at a relatively adult age with a slight female preponderance. Fever, Pallor, fatigue and weight loss were the commonest presentations and hepatosplenomegaly, Splenomegaly, Lympadenopathy and anemia were the common signs.

Keywords: acute leukemia, clinopathology, hepatomegaly, splenomegaly.


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