Revisiting the complete blood count and clinical findings at diagnosis of childhood acute lymphoblastic leukemia: 10-year experience at a single center
Revisiting the complete blood count and clinical findings at diagnosis of childhood acute lymphoblastic leukemia: 10-year experience at a single center
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DOI：
10.1016/j.htct.2018.05.010
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发表时间：
2019-03-01
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影响因子：
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通讯作者：
Gómez-Almaguer, David
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文献类型：
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作者：
Jaime-Pérez, José Carlos;García-Arellano, Gisela;Gómez-Almaguer, David
背景：急性淋巴细胞白血病的临床和实验室诊断存在异质性。在诊断为急性淋巴细胞白血病的开放人群中，对西班牙裔儿童的全血细胞计数异常及其组合、症状和体格检查结果的频率进行了研究。16岁以下的病历和电子记录-对在一所大学医院的区域血液学中心诊断为急性淋巴细胞白血病10年以上的老年儿童进行分析，以检索有关首次评估时的全血细胞计数。结果：回顾性分析2006 - 2016年诊断为急性淋巴细胞白血病的203例0-15岁儿童的临床资料。血液检查结果显示白色血细胞计数中位数为7120 × 10（9）/L（范围：450- 600，000 x 10（9）/L），中位血红蛋白浓度为7.5 g/dL（范围：2.4-15.3 g/dL），而血小板计数中位数为47，400 x 10（9）/L（范围：4000- 544，000 x 10（9）/L）。白细胞增多和白细胞减少分别占36.6%和36.1%，82.9%的儿童被诊断为贫血。主要临床症状出现频率依次为乏力62%、发热60%、骨关节疼痛39%、食欲减退33%、体重下降21%;主要体征依次为肝肿大78%、脾肿大63%、淋巴结肿大57%、面色苍白48%、紫癜30%。在一个10年以上的西班牙裔儿童队列中记录了与儿童急性淋巴细胞白血病诊断时经典预期不同的数据，这些儿童具有广泛的全血细胞计数异常，表现形式和物理发现的频率。(C)2018年巴西血液学协会，Hemoterapia e Terapia Celular。出版社：Elsevier Editora Ltda
Background: Heterogeneity regarding clinical and laboratory findings at diagnosis of acute lymphoblastic leukemia exists. The frequency of complete blood count abnormalities and its combinations, symptoms and physical findings were investigated in Hispanic children from an open population at the diagnosis of acute lymphoblastic leukemia.Methods: The patient charts and electronic records of under 16-year-old children diagnosed with acute lymphoblastic leukemia over 10 years at a regional hematology center of a university hospital were analyzed to retrieve data concerning the complete blood count at first evaluation. Type and distribution of abnormal data, frequency of symptoms and physical findings at presentation were documented.Results: The records of 203 children aged 0-15 years diagnosed with acute lymphoblastic leukemia from 2006 to 2016 were revisited. The results of the blood workup showed a median white blood cell count of 7120 x 10(9)/L (range: 450-600,000 x 10(9)/L), and a median hemoglobin concentration of 7.5 g/dL (range: 2.4-15.3 g/dL), whereas the median platelet count was 47,400 x 10(9)/L (range: 4000-544,000 x 10(9)/L). Leukocytosis and leukopenia were present in 36.6% and 36.1% of cases, respectively; anemia was diagnosed in 82.9% children. The order of frequency for major clinical symptoms was fatigue 62%, fever 60%, bone and joint pain 39%, hyporexia 33% and weight loss 21%, while main physical findings were hepatomegaly 78%, splenomegaly 63%, lymphadenopathy 57%, pallor 48%, and purpura 30%.Conclusion: Data differing from those classically expected at diagnosis of acute lymphoblastic leukemia in children were documented in a cohort of Hispanic children over one decade with a wide spectrum of complete blood count abnormalities, forms of presentation and frequency of physical findings. (C) 2018 Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda.