JOURNAL BROWSE
Search
Advanced SearchSearch Tips
Acute Lymphoblastic Leukemia in Adults - an Analysis of 51 Cases from a Tertiary Care Center in Pakistan
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Acute Lymphoblastic Leukemia in Adults - an Analysis of 51 Cases from a Tertiary Care Center in Pakistan
Sultan, Sadia; Irfan, Syed Mohammed; Parveen, Saira; Mustafa, Sanober;
  PDF(new window)
 Abstract
Background: Acute lymphoblastic leukemia (ALL) is a malignant disease in which early lymphoid precursors proliferate and replace the normal hematopoiesis. It has distinctive clinical and biological features. In respect to adult ALL, available data from Pakistan are limited. Therefore we reviewed the demographical and clinicohematological profiles along with FAB stratification of adult patients with ALL presented at our hospital. Materials and Methods: In this cross sectional study, 51 adults () patients with ALL were enrolled from January 2010 to December 2014. Results: The mean age was with the median age of 18.0 years. The male to female ratio was 2:1. The major complaints were fever (60.7%), generalized weakness (47.0%), overt bleeding (19.6%) and weight loss (13.7%). Physical examination revealed lymphodenopathy as a predominant finding detected in 43.1% followed by splenomegaly and hepatomegaly in 23.5% and 21.5%, respectively. The mean hemoglobin level was with a mean MCV of , a mean total leukocyte count of , a mean ANC of and a mean platelet count of . According to FAB classification, 47.1% were L1 type, 45.1% L2 and 7.8% L3 variant. Conclusions: Clinico-pathological features appeared comparable to published data. Febrile illness associated with lymphodenopathy was the commonest presentation. FAB classification revealed a predominance of ALL-L1 variant in Pakistani adult patients with ALL.
 Keywords
Acute lymphoblastic leukemia;adults;Pakistan;
 Language
English
 Cited by
 References
1.
Asif N, Hassan K (2013). Acute Myeloid Leukemia amongst Adults. J Islamabad Med Dental College, 2, 58-63.

2.
Bennettt JM, Catovsky D, Daniel MT (1976). Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol, 33, 451-8. crossref(new window)

3.
De Franca Azevedo I, da Silva Junior RM, de Vasconcelos AV, et al (2014). Frequency of p190 and p210 BCR-ABL rearrangements and survival in Brazilian adult patients with acute lymphoblastic leukemia. Rev Bras Hematol Hemoter, 36, 351-5. crossref(new window)

4.
Elyamany G, Awad M, Alsuhaibani O, et al (2014). FLT3 Internal Tandem Duplication and D835 Mutations in Patients with Acute Lymphoblastic Leukemia and its Clinical Significance. Mediterr J Hematol Infect Dis, 6, 2014038. crossref(new window)

5.
Greaves M (2006). Infection, immune responses and aetiology of childhood leukaemia. Nat Rev Cancer, 6, 193-203. crossref(new window)

6.
Goud TM, Al Salmani KK, Al Harasi SM, et al (2015). Importance of FISH combined with morphology, immunophenotype and cytogenetic analysis of childhood/ adult acute lymphoblastic leukemia in omani patients. Asian Pac J Cancer Prev, 16, 7343-50. crossref(new window)

7.
Hassan K, Ikram N, Shah SH (1994). A morphological pattern of 234 cases of leukemias. J Pak Med Assoc, 44, 145-8.

8.
Hayakawa F, Sakura T, Yujiri T, et al (2014). Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group. Blood Cancer J, 17, 4-252.

9.
Islam N, Rahman MM, Aziz MA, et al (2014). Clinical and haemato-pathological characteristics of adult acute lymphoblastic leukaemia. Mymensingh Med J, 23, 281-5.

10.
Jemal A, Siegel R, Ward E, et al (2006). Cancer statistics.CA Cancer J Clin, 56, 106-30. crossref(new window)

11.
Jiang Y, Hou J, Zhang Q, et al (2013). The MTHFR C677T polymorphism and risk of acute lymphoblastic leukemia: an updated meta-analysis based on 37 case-control studies. Asian Pac J Cancer Prev, 14, 6357-62. crossref(new window)

12.
Khalid A, Zahid M, Rehman A, et al (1997). Clinicoepidemiological features of adult leukemias in Pakistan. J Pak Med Assoc, 47, 119-22.

13.
Mashhadi MA, Koushyar MM, Mohammadi M (2012).Outcome of adult acute lymphoblastic leukemia in South East of iran (zahedan). Iran J Cancer Prev, 5, 130-7.

14.
Malhotra P, Varma S, Varma N, et al (2007). Outcome of adult acute lymphoblastic leukemia with BFM protocol in a resource-constrained setting. Leuk Lymphoma, 48, 1173-8. crossref(new window)

15.
NCCN-National comprehensive cancer network, clinical practice guidelines in oncology, acute lymphoblastic leukemia, version 2015, MS2.

16.
Pui CH, Robison L, Look AT (2008). Acute lymphoblastic leukemia. Lancet, 354, 166-178.

17.
Seiter K (2014). Sarkodee-Adoo, C; Talavera, F; Sacher, RA; Besa, EC, ed. "Acute Lymphoblastic Leukemia". Medscape Reference. WebMD. Retrieved 17 April 2014.

18.
Sabir N, Iqbal Z, Aleem A, et al (2012). Prognostically significant fusion oncogenes in Pakistani patients with adult acute lymphoblastic leukemia and their association with disease biology and outcome. Asian Pac J Cancer Prev, 13, 3349-55. crossref(new window)

19.
Shaikh MS, Adil SN, Shaikh MU, Khurshid M (2014). Frequency of chromosomal abnormalities in Pakistani adults with acute lymphoblastic leukemia. Asian Pac J Cancer Prev, 15, 9495-8. crossref(new window)

20.
Shahab F, Raziq F (2014). Clinical presentations of acute leukemia. J Coll Physicians Surg Pak, 24, 472-6.

21.
Tong H, Zhang J, Lu C, et al (2010). Immunophenotypic, cytogenetic and clinical features of 113 acute lymphoblastic leukaemia patients in China. Ann Acad Med Singapore, 39, 49-53.

22.
Wartenberg D, Groves FD, Adelman AS (2008). Acute lymphoblastic leukemia: epidemiology and etiology. In: Estey EH, Faderl S, Kantarjian H, eds. Acute Leukemias. 1st ed. Berlin, Germany: Springer; 2008, 77-93.