Prognostic Factors of Acute Lymphoblastic Leukeamia in Children

Objective To look into the known prognostic factors of Acute Lymphoblastic Leukeamia in Children Materials and Methods: A retrospective study on children with a diagnosis of acute lymphoblastic leukeamia was conducted at Oncology department, Children Hospital, Pakistan Institute of Medical Sciences Islamabad. All the Leukaemic patients registered form January 2007- August 2009 were included in this study. Their detailed clinical history specially age, sex, lymphadenopathy, hepatosplenomegaly, testicular enlargement, mediastinal masses as well as the CNS disease was thoroughly interrogated. All preinduction investigations including Haemoglobin level, white blood cell Count, Platelet count, peripheral blast count and bone marrow blast count were noted and compared with the post induction values. Results: Among the children having acute lymphoblastic leukeamia the mean age of presentation was 5 years four month with male to female ratio of 2:1. 58% of patients had hepatomegaly and 60 % had splenomegaly. Pre-induction bone marrow blast count in majority of the patients was 80%. Pre-induction mean WBC count was 26.3 x 10^9, mean Hb was 7.1 g/dl, and mean platelet count was 77.1 x 10^9. The post-induction WBC count was 3.5 x 10^9, mean Hb was 8.9 g/dl and platelet count was 174.2 x 10^9. Regarding the FAB classification, 60% of the cases were of ALL-L1; these patients showed a good response in 86% and were categorized prognostically as M1 [on post- induction blast count basis]. Conclusions: Majority of children with ALL had ALL-L1 morphology, having pre-induction bone marrow blast cell count of 80%, which reduced to 1% with multi-agent induction therapy.