"Morphological and Immunophenotypic characteristics of Aeute Leukaemia in children:A Observational studyDhaka, Bangladesh" (original) (raw)
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Correlation of Bone Marrow Morphology and Immunophenotyping in Acute Leukaemia Patients
Haematology Journal of Bangladesh, 2020
Background: Acute leukaemia (AL) is a malignant disorder of the blood that is characterized by blocked or impaired differentiation of haemopoietic stem cells, resulting in abnormal accumulation of immature precursors and suppression of growth and maturation of cells in vivo. Objective: To find out correlation between morphological and immunophenotypic study of bone marrow among acute leukaemia patient. Methods/Procedure: This is a comparative cross sectional study of diagnosis of leukaemia by bone marrow study and immunophenotyping from bone marrow sample with bone marrow alone of suspected cases of leukaemia treated in the department of haematology in Dhaka Medical College Hospital (DMCH)from March 2013 to August 2013 .Bone marrow examination and immunophenotyping was done simultaneously but having bone marrow morphology report we have compared with flow report. Results: Out of 50 patients according to Bone marrow study (BMS) 25(50.0%) of the patients had acute myelogenous leukaem...
Journal of Evolution of Medical and Dental Sciences, 2019
BACKGROUND Leukaemias are characterised by abnormal proliferation of haematopoietic cells, causing progressive infiltration of the marrow. It is the eleventh most common cancer in the world, and increasingly found now. Two widely used classifications are currently used, the FAB, and the WHO classification, which has got supplanted now, with increasing knowledge on cytomorphology and cytogenetics. This study attempts to evaluate the role of cytochemistry in various types of leukaemias, as well as the role of immunophenotyping in a select few cases, which were referred to the Department of Pathology, at Thanjavur Medical College. We wanted to study, the types and subtypes of leukaemias using cytochemistry, their morphology, the demographic distribution and their clinical and haematological presentation. METHODS The present study had a sample size of 56 cases of leukaemia, diagnosed in the department of pathology, Thanjavur Medical College. Those cases referred to the Department of pathology, with clinical suspicion, were subjected to peripheral smear study by standard Romanowsky stains first, mainly by Leishman's stain and a presumptive diagnosis was made. Following which peripheral blood smears were subjected to special cytochemical stains using Sudan Black B (SBB) and Periodic Acid Schiff's reagent stain (PAS). The percentage of blast cells were enumerated, and the cytomorphology studied based on their positive staining effects on the respective blood smears. Thereby, the types and subtypes of leukaemias were classified and reported as per FAB classification. Relevant clinical history was obtained from each case, with parameters relating to splenomegaly, hepatomegaly, and lymphadenopathy. Haematological investigations were done on a three-part automated cell counter, and values pertaining to haemoglobin, total count, and platelet count were also noted. Clinical and haematological correlation was thus made with the diagnosed cases, and statistical analysis was undertaken. In six cases, immunophenotyping using flow cytometry, and standard panel markers, was undertaken; when in doubt, its concordance patterns were also noted. RESULTS 56 cases of leukaemia, identified by morphology and cytochemistry, were seen in the study between January 2015 and June 2015. Cytochemical stains used were Sudan black B, and PAS. Out of the total, 36 cases were acute, rest were chronic cases. AML accounted for 43% of the cases, followed by CML at 33%, and ALL at 22%. A slight female preponderance was seen in the number of AML cases, but a male predominance was seen in ALL. ALL was common in the child age group, followed by AML, and CML in the 21-40 age group, followed by AML. CLL was seen mostly above 40 yrs. of age. Anaemia was more in acute leukaemias especially ALL, followed by AML. Total count values were high in CML, followed by AML. Platelet counts were less in acute leukaemias, especially ALL, followed by AML. Splenomegaly was the commonest feature seen in 21 cases. Immunophenotyping was done in 6 cases, 4 cases were concordant, showing a 67% rate. CONCLUSIONS In a setting where there is a lack of facilities for flow cytometry, as in majority of centres in the developing countries, morphology combined with cytochemistry, still serves as the best means in diagnosing leukaemia cases.
Immunophenotyping Pattern in Childhood Acute Leukemia in the Adam Malik Hospital Medan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY
Leukemia is the most common malignancy at the age of under 15 years, with a ratio of 1 to 3 cancer cases in children.Immunophenotyping will improve accuracy and easily provide data reproducibility. To determine the immunophenotypingpattern in patients with acute leukemia in the Pediatric Center at the Adam Malik General Hospital, Medan. This research wasa cross-sectional study in children suffering from acute leukemia in the Pediatric Unit Adam Malik General Hospital, Medanbased on CBC, peripheral smear, bone marrow morphology, and flow cytometry immunophenotyping. Samples wereevaluated for blast morphologic and immunophenotyping was carried out. Results of morphologic observation andimmunophenotyping were compared. From 20 samples using the monoclonal antibody with flow cytometryimmunophenotyping, concordance with morphology is good (κ = 0.886). After classification, the percentage of acuteleukemia was 45% B-ALL, 35% AML, and 20% T-ALL. One of 10 samples morphologically classified...
Evaluation of Acute Lymphoblastic Leukemia Using Cytochemical Staining
Lymphoblastic leukemia based on cell morphology dominant coloring Cytochemical into three main groups: 1L, 2L, 3L classify, Although the clinical value of the expected lifespan in adults is unknown,but in terms of prognosis and clinical course and response to treatment methods in children is important.109 peripheral blood samples from patients suspected of Razi Hospital Hematology Center was developed leukemia, and follows Cytochemical staining was performed on each sample,19 samples by alpha-naphthalen propanoic acetate esterase staining positive 15/78 percent and 84/21 percent were negative.Of the 12 samples analyzed by acid phosphatase staining was found that 25% of the samples were positive and 75% negative, also the 25 samples that were analyzed by alkaline phosphatase staining, 100% of the negative and none of the samples were positive, and 34 samples were examined by staining Periodic acid shifts 97/55% of the negative samples and only 2/94 percent positive, and from 12 samples by staining was evaluated Naphthile AS-D 16/66% positive and 83/33% of the samples were negative.The diagnosis of leukemia, the disease situation and select pin for the treatment of all cases with morphological characteristics of the cells was not possible,therefore, to reach the correct diagnosis Cytochemical tests and immune cell phenotype and cytogenetic studies are needed.
Acute Leukaemias on Bone Marrow Examination and Clinical Manifestations in the Telangana Population
International Journal of Integrative Medical Sciences, 2018
These lymphoid and myeloid leukemias are associated with varied systemic involvement such as anemia, splenomegaly, generalized lymphadenopathy and petechial haemorrhagic spots. For this reason, the clinician also requires the basic peripheral blood smear study as a preliminary examination to differentiate the various diseases that overlap the symptomatology of acute leukemia clinically. With this background we examined bone marrow and clinical manifestations for rule out the acute leukaemias in Telangana population. During the 25 months of study a total of 36 cases of leukaemias were studied in the Department of pathology, Kakatiya Medical College, Warangal in collaboration with Lifeline Diagnostics, Hyderabad. Out of 36 cases, 20 cases were AML, 15 cases were ALL and 1 case was mixed phenotypic acute leukaemia. The highest number of cases in the adults belonged to AML (16 cases). In children ALL (13cases) formed the majority of cases followed by AML (4 cases). The most common presentation in the study population followed by splenomegaly (38.8%). Out of the AML cases studied, 13 cases were diagnosed by morphology alone and in 5 cases, cytogenetic study helped in sub typing the cases. Out of the ALL cases studied 5 cases were diagnosed by morphology alone and in 3 Cases, cytogenetic studies confirmed the diagnosis. MPO stain was done on all cases of acute leukaemias and (20 cases) out of these showed positivity favouring a diagnosis of AML. PAS stain was done on all cases, (7 cases) of which showed block positivity favouring a diagnosis of ALL.
Scenario of Acute Lymphoblastic Leukaemia in Gwalior Region
Journal of Evolution of Medical and Dental Sciences, 2016
BACKGROUND Leukaemia is the most prevalent childhood cancer and Acute Lymphoblastic Leukaemia (ALL) constitutes about 75% of all cases. The most frequent presenting symptoms are fever, weight loss and pallor. Early diagnosis of this haematological malignancy can be helpful for prognosis of disease. AIMS AND OBJECTIVES The objectives of the present study were to assess frequency of presenting symptoms, laboratory data and prognostic factors in children with diagnosis of ALL. MATERIALS AND METHODS The present study (2014) was performed in the Department of Pathology of Gajra Raja Medical College, Gwalior, over a period of one year from October 2013 to September 2014. The blood samples were received from patients attending various Departments of Jayarogya Groups of Hospitals, a tertiary care hospital. RESULTS Out of the 37 cases diagnosed as Acute Lymphoblastic Leukaemia, 25 (67.57%) were male and 12 (32.43%) were female, (male:female ratio: 2.1:1); 43.35% of patients which comprises highest number of cases belonged to 11-20 years of age group. The most frequent presenting symptoms was fever (83.78%) followed by weakness (70.27%) and loss of appetite (27%), while most frequent presenting sign was pallor (86.48%) followed by lymphadenopathy (67.57%) and splenomegaly (48.65%)). Complete blood cell count was abnormal in all of the patients and pancytopenia was detected in 10.81% of the patients. Of all the patients, 91.89% had abnormal White Blood Cell (WBC) count at presentation with about 80% were presented with Leukocytosis. FAB L1 subtype was more common as compared to FAB L2 subtype. CONCLUSION In our study (2014), Acute Lymphoblastic Leukaemia was more prevalent in males than in females and more common in childhood than in adult. FAB L1 subtype was more common as compared to FAB L2 subtype.
Althea Medical Journal
Background: Acute lymphoblastic leukemia (ALL) is a disease caused by a mutation of lymphoid progenitor cells in bone marrow, that induces uncontrolled lymphoid cell proliferation. ALL is the most common type of leukemia in children. Various clinical and laboratory manifestation makes the diagnostic process more complicated. This study aimed to observe the clinical and laboratory manifestation of children with ALL in Dr. Hasan Sadikin General Hospital for diagnostic and assessment. Methods: The design of this study was a descriptive cross-sectional with a total sampling method. Data of all children under 18 years old with ALL diagnosed in 2015 to 2017 were included. The diagnosis of ALL was confirmed by examination of hematology indices, peripheral blood smear, and bone marrow aspiration classified by FAB. Inaccessible or incomplete medical records were excluded. Results: In total, 192 data of ALL patients were included. Most ALL patients predominantly occurred in boys (59.9%), and the age group of 1-5 years old (40.6%). The clinical manifestations were pallor (89.6%), hepatomegaly (79.7%) and fever (75%). Most patients experienced severe anemia with hemoglobin level <7g/dL (44.8%), leukocytosis >20.000 cells/mm3 (46.9%), severe thrombocytopenia with platelet count <20.000 cells/mm3 (51%), and blast cells count >50% (45.3%). Based on FAB classification, the majority of the patients were classified as ALL type L2 (65.6%). Conclusions: Clinical and laboratory manifestation of ALL patients can be used as a parameter for diagnostic and assessment of severity. Earlier diagnosis would result in better prognosis and more precise treatment for ALL patients.
PLOS ONE, 2015
Bone marrow architecture is grossly distorted at the diagnosis of ALL and details of the morphological changes that accompany response to Induction chemotherapy have not been reported before. While marrow aspirates are widely used to assess initial response to ALL therapy and provide some indications, we have enumerated marrow components using morphometric analysis of trephine samples with the aim of achieving a greater understanding of changes in bone marrow niches. Morphometric analyses were carried out in the bone marrow trephine samples of 44 children with ALL, using a NanoZoomer HT digital scanner. Diagnostic samples were compared to those of 32 control patients with solid tumors but without marrow involvement. Samples from patients with ALL had significantly increased fibrosis and the area occupied by bony trabeculae was lower than in controls. Cellularity was higher in ALL samples due to leukemic infiltration while the percentage of normal elements such as megakaryocytes, adipocytes, osteoblasts and osteoclasts were all significantly lower. During the course of Induction therapy, there was a decrease in the cellularity of ALL samples at day 15 of therapy with a further decrease at the end of Induction and an increase in the area occupied by adipocytes and the width of sinusoids. Reticulin fibrosis decreased throughout Induction. Megakaryocytes increased, osteoblasts and osteoclasts remained unchanged. No correlation was found between clinical presentation, early response to treatment and morphological changes. Our results provide a morphological background to further studies of bone marrow stroma in ALL.
Spectrum of leukemia at tertiary care hospital
IP innovative publication pvt ltd, 2020
Introduction: Acute leukemia are characterized by clonal expansion of immature myeloid or lymphoid precursors (blasts). The blasts cells are known to replace the normal hematopoietic tissues and to invade other organs of the body as well. Anemia, hemorrhage and infections occurring due to bone marrow failure are the top three complications of acute leukemia & chronic leukemia. Materials and Methods: In this study the various types of leukaemia distribution carried out at tertiary care Hospital among various ethnic groups, in terms of types, age, sex. This retrospective study over a five years period between January 2014 to December 2018, carried out in the department of Pathology, at tertiary care Hospital. Diagnosis was done with the help of peripheral blood count, peripheral blood smear and bone marrow examination for morphology along with cytochemistry study whenever required. FAB classification is followed in the present study. Results: Different patterns of acute leukemia were reported, in the present study. According to haematological parameters, following cases of acute leukemia 128 cases (69.18%), & chronic leukemia of 55 cases (29.72 %) were reported. Also 47 cases (25.40%) & 8 cases (4.32%) were reported as CML & CLL respectively. Conclusions: The present study showed that AML is more common than ALL. It is observed that ALL is more common ly seen in children. The incidence of AML is higher in adults in comparison to children and decreases towards older age.