A retrospective study of acute lymphoblastic leukaemia in Paediatric patients at Dr George Mukhari Hospital (2003-2007)

Abstract

Introduction: ALL (Acute Lymphoblastic Leukaemia) is the most common leukaemia in childhood. The two most important features predictive of outcome are age and presenting WBC at diagnosis. NCI risk criteria are applied to all children with precursor B-ALL, dividing them into NCI “high risk” (age < 1 year and ≥ 10 yrs, WBC > 50 x 10 9/ ) and NCI “standard risk” (age ≥ 1 year and < 10 yrs, WBC < 50 x 10 9/ ). Gender, immunophenotyping and genetic studies are other features that have been shown to be associated with outcome.

Objectives: To determine the correlation between survival outcome of paediatric patients with ALL and different variables, e.g. biological, haematological, immunophenotypic and cytogenetic features at diagnosis, and to determine the duration of survival of a patient since the diagnosis of ALL, at Dr George Mukhari Hospital.

Methods: This study was conducted over the period 2003-2007. Children diagnosed with ALL with ages ranging from 1-12 years, were identified. The hospital and laboratory records were analysed retrospectively. Early prognostic features were identified from patient data.

Results: Descriptive statistical measures were used to summarize data. Twenty nine paediatric patients with ALL were identified of which 12 were female and 17 were male. The mean age of patients at diagnosis was 7,2 years. The presenting leucocyte count ranged from 2,5 to 325 x 10 9/ . Cytogenetic studies of three patients were available, all of which were unfavourable prognostic factors. Immunophenotyping revealed ten patients with T-cell ALL, 17 patients with B-cell ALL and two patients whose immunophenotype was unknown as recorded results were not available. Twenty one patients’ survival data were known. The longest duration of survival of a patient was 3,7 years. There were seven patients known to be alive at the end of the study period.

Conclusion: The cases reported herein and those described in the literature demonstrate the importance of a careful and multidisciplinary approach in the diagnosis and evaluation of paediatric ALL.