Spectrum of acute and chronic leukemia at a tertiary care hospital, Haryana, India

Authors

  • Gajender Singh Department of Pathology, Pt BD Sharma, PGIMS, Rohtak, Haryana
  • Padam Parmar Department of Pathology, Pt BD Sharma, PGIMS, Rohtak, Haryana
  • Sant Prakash Kataria Department of Pathology, Pt BD Sharma, PGIMS, Rohtak, Haryana
  • Sunita Singh Department of Pathology, Pt BD Sharma, PGIMS, Rohtak, Haryana
  • Rajeev Sen Department of Pathology, Pt BD Sharma, PGIMS, Rohtak, Haryana

DOI:

https://doi.org/10.18203/2320-6012.ijrms20160792

Keywords:

Leukemias, Acute/chronic myeloid and lymphoid subtype

Abstract

Background: Leukemias are primary neoplasms arising from the malignant proliferations of blood cells or their precursors. Leukemias are classified into acute/chronic myeloid and lymphoid subtype. Typing of leukemia is essential for effective therapy because prognosis and survival rate are different for each type and sub-type.

Methods: A total of 356 patients diagnosed to have acute/chronic leukemia were included in our study. Only newly diagnosed cases were included in this study and patients on cancer treatment and other primary hematological malignancies like lymphomas, plasma cells disorders and metastatic deposits were excluded. Findings of bone marrow aspiration and peripheral blood were interpreted in respect to history and clinical examination. FAB classification of acute leukemia was applied for sub-typing.

Results: In our study, 66.8% of patients had acute leukemia while 33.2% had chronic leukemia. Overall male preponderance was found comprising 56.46% of all cases. Male to female ratio was 1.5:1. Acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) were found in 29.7% and 37.3% of the patients respectively. Of chronic type leukemia, 28.3% patients had chronic myeloid leukemia (CML) and only 4.7% had chronic lymphocytic leukemia (CLL). L2 was the most common (49.2%) subtype in ALL, followed by L1 (43.3%). AML sub-typing revealed M3 was the most common (50%), followed by M2 (28.7%).  Adult patients (70.5%) were more commonly affected than children (29.5%). In paediatric patients ALL was the predominant diagnosis (65.71%), whereas in adult AML cases were maximum (77.27%).

Conclusions: Detailed hematological analysis including peripheral blood and bone marrow aspiration smears examination with cytogentic analysis are necessary for early and definite diagnosis and effective management of hematological malignancies.

 

References

Harris NL, Jaffe ES,Vardiman JW, Stein H, Diabold J, Flandrin G. WHO Classification of tumors of haematopoietic and lymphoid tissues- Introduction. In: Harris NL, Jaffe ES,Vardiman JW, editors. Pathology and genetics of tumors of haematopoietic and lymphoid tissues. Lyon France: IARC press; 2008: p 1-15.

Salkar AB, Patrikar A, Bothale K, Malore S, Salkar A, Modani S. Clinicohematological evaluation of leukemias in a tertiary care hospital. IOSR-JDMS. 2014;13:126-34.

McKenna RW. Multifaceted Approach to the Diagnosis and Classification of Acute Leukemias. Clin Chem. 2000;46:1252-9.

Arber DA, Cousar J. Hematopoeitic Tumors: Principles of pathologic diagnosis. In: Greer JP, Rodgers GM, Foerster J, Paraskevas F, Lukens JN, Glader B, editors. Wintrobe’s Clinical Hematology.13th edition, vol 2. Philadelphia: Lipincotts Williams and Wilkins; 2014: p 1663- 68.

Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR et al. Proposal for the classification of the acute leukaemias. French American British (FAB) Cooperative group. Bri J of Haematol. 1976;33:451-8.

Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnik HR et al. Proposed revised criteria for the classification of acute myeloid leukemia: A report of the French – American-British Co-operative group. Ann Int Med. 1985;103:620-9.

Bain BJ, Baits I. Approach to the diagnosis and classification of blood diseases. In: Lewis SM, Bain BJ, Baits I, editors. Dacie and Lewis Practical Haematology. 11th ed. Philadelphia; Churchill Livingstone: 2012: p. 549-63.

Nasim N, Malik K, Malik NK, Mobeen S, Awan S, Mazhar M. Investigation on the prevelance of leukemia at a tertiary care hospital, Lahore. Biomedica. 2013;29:19-22.

Humayun M, Khan SA, Muhammad W. Investigation on the prevalence of leukemia in North West Frontier Province of Pakistan. TJC. 2005;35(3):119-22.

Rego MF, Pinheiro GS, Metze K, Lorand-Metze I. Acute leukemias in Piaui: comparison with features observed in other regions of Brazil. Brazilian Journal of Medical and Biological Research. 2003;36(3):331-7.

Harani MS, Adil SN, Shaikh MU, Kakepoto GN, Khurshid M. Frequency of FAB subtypes in acute myeloid leukemia patients at Aga Khan University Hospital Karachi. J Ayub Med Coll Abbottabad. 2005;17:26-9.

Braham-Jmili N, Sendi-Senana H, Labiadh S, Ben Abdelali R. Hematological characteristics, FAB and WHO classification of 153 cases of myeloid acute leukemia in Tunisia. Ann Biol Clin. 2006;64:457-65.

Ullah K, Ahmed P, Raza S, Satti TM, Chaudhry QU, Akhtar F, Kamal MK , et al. Management of acute myeloid leukemia- 5 years experience at Armed Forces Bone Marrow Transplant Centre. Rawalpindi. J Pak Med Assoc. 2007;57:434-9.

Gupta R, Kaul KK, Dewan D. Clinicomorphological profile in acute leukemias: experience from a tertiary care centre in Jammu. Indian J Res. 2015;4:4-6.

Hasanbegovic E. Clinical and hematologic features of pediatric leukemias. Med Arh. 2006;60:84-6.

Paul B, Mukiibi JM, Mandisodza A, Levy L, Nkrumah FK. A three-year study of 137 cases of acute leukaemia in Zimbabwe. Cen Afr J Med. 1992;38:95-9.

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Published

2016-12-28

How to Cite

Singh, G., Parmar, P., Kataria, S. P., Singh, S., & Sen, R. (2016). Spectrum of acute and chronic leukemia at a tertiary care hospital, Haryana, India. International Journal of Research in Medical Sciences, 4(4), 1115–1118. https://doi.org/10.18203/2320-6012.ijrms20160792

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Original Research Articles