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Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia
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 clinicop...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418085/ https://www.ncbi.nlm.nih.gov/pubmed/25992344 http://dx.doi.org/10.4103/2278-330X.155648 |
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author | Raja, Shruti Suman, Febe Renjitha Scott, Julius Xavier Latha, M. S. Rajenderan, Aruna Ethican, Abhirami |
author_facet | Raja, Shruti Suman, Febe Renjitha Scott, Julius Xavier Latha, M. S. Rajenderan, Aruna Ethican, Abhirami |
author_sort | Raja, Shruti |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4418085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-44180852015-05-19 Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia Raja, Shruti Suman, Febe Renjitha Scott, Julius Xavier Latha, M. S. Rajenderan, Aruna Ethican, Abhirami South Asian J Cancer MINI SYMPOSIUM: PEDIATRIC ONCOLOGY 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. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4418085/ /pubmed/25992344 http://dx.doi.org/10.4103/2278-330X.155648 Text en Copyright: © South Asian Journal of Cancer http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | MINI SYMPOSIUM: PEDIATRIC ONCOLOGY Raja, Shruti Suman, Febe Renjitha Scott, Julius Xavier Latha, M. S. Rajenderan, Aruna Ethican, Abhirami Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
title | Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
title_full | Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
title_fullStr | Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
title_full_unstemmed | Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
title_short | Pancytopenia – (?) An obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
title_sort | pancytopenia – (?) an obstacle in the diagnosis and outcome of pediatric acute lymphoblastic leukemia |
topic | MINI SYMPOSIUM: PEDIATRIC ONCOLOGY |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418085/ https://www.ncbi.nlm.nih.gov/pubmed/25992344 http://dx.doi.org/10.4103/2278-330X.155648 |
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