CORRELATION BETWEEN ANAEMIA AND THROMBOCYTOPENIA IN YOUNGER PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKAEMIA
Abstract
Background: Thrombocytopenia needs careful attention of the physician for immediate management to avoid complications. Limited local data is available on low platelet count among patients of all age group on diagnosis of acute lymphoblastic leukaemia (ALL). The aim of this study was to assess the frequency and correlation of anaemia and liver function tests with thrombocytopenia among patients diagnosed with ALL. Methods: A prospective study was conducted on patients diagnosed with ALL at Hayatabad Medical Complex, Peshawar. Age, gender, presence of anaemia and deranged liver function tests were correlated with low platelet count in patients with ALL. Results A total of 90 patients diagnosed with ALL at the department during the study period were included in the study. Mean age of the patients was 15.43±4.756 years. Among these, 64 (71.1%) were male and 26 (28.9%) patients were female. Low platelet count was observed in 41 (45.5%) of the patients while 49 (54.5%) had platelet count within the range. Low haemoglobin levels were strongly related to presence of low platelet count in our target population (p<0.001). Deranged liver functions were not significantly correlated to thrombocytopenia in patients with ALL. Conclusion: Low platelet count was a common finding at the time of diagnosis among patients diagnosed with acute lymphoblastic leukaemia. Presence of anaemia was statistically significantly correlated with presence of low platelet count among the patients at the time of diagnosis of ALL.
Pak J Physil 2021;17(2):7–9
References
Hao T, Li-Talley M, Buck A, Chen W. An emerging trend of rapid increase of leukemia but not all cancers in the aging population in the United States. Sci Rep 2019;9(1):12070.
Miranda-Filho A, Piñeros M, Ferlay J, Soerjomataram I, Monnereau A, Bray F. Epidemiological patterns of leukaemia in 184 countries: a population-based study. Lancet Haematol 2018;5(1):e14–24.
Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J 2017;7(6):e577.
Tomaiuolo M, Brass LF, Stalker TJ. Regulation of platelet activation and coagulation and its role in vascular injury and arterial thrombosis. Interv Cardiol Clin 2017;6(1):1–12.
Skipper MT, Rubak P, Stentoft J, Hvas AM, Larsen OH. Evaluation of platelet function in thrombocytopenia. Platelets 2018;29(3):270–6.
Zhang Y, Gu H, Chen Q, Zhang Y, Cheng H, Yang J, et al. Low platelet counts at diagnosis predict better survival for patients with intermediate-risk acute myeloid leukemia. Acta Haematol. 2020;143(1):9–18.
Jaime-Pérez JC, García-Arellano G, Herrera-Garza JL, Marfil-Rivera LJ, Gómez-Almaguer D. Revisiting the complete blood count and clinical findings at diagnosis of childhood acute lymphoblastic leukemia: 10-year experience at a single center. Hematol Transfus Cell Ther 2019;41(1):57–61.
Grunnan JD, Rosthøj S. Time course of peripheral blood count recovery during induction chemotherapy for childhood acute lymphoblastic leukemia. Hematology 2019;24(1):467–72.
Bayhan T, Ünal Ş, Gümrük F, Çetin M. Immune thrombocytopenic purpura during maintenance phase of acute lymphoblastic leukemia: a rare coexistence requiring a high degree of suspicion, a case report and review of the literature. Turkish Hematol 2015;32(4):363.
Gu RL, Xiang M, Suo J, Yuan J. Acute lymphoblastic leukemia in an adolescent presenting with acute hepatic failure: A case report. Mol Clin Oncol 2019;11(2):135–8.
Ford J, Rainey S, Hanson K, Kendhari H. Acute lymphoblastic leukemia presenting as cholestatic jaundice in a 7-year-old boy. SAGE Open Med Case Rep 2019;7:2050313X19875318.
Sultan S, Irfan SM, Parveen S, Mustafa S. Acute Lymphoblastic Leukemia in Adults - an Analysis of 51 Cases from a Tertiary Care Center in Pakistan. Asian Pac J Cancer Prev 2016;17(4):2307–9.
Coccia PF, Pappo AS, Beaupin L, Borges VF, Borinstein SC, Chugh R, et al. Adolescent and young adult oncology, version 2.2018, NCCN clinical practice guidelines in oncology. J Nat Compr Cancer Netw 2018;16(1):66–97.
Vallacha A, Haider G, Raja W, Kumar D. Remission Rate of Acute Lymphoblastic Leukemia (ALL) in Adolescents and Young Adults (AYA). J Coll Physicians Surg Pak. 2018;28(2):118–21.
Cooper N, Ghanima W. Immune thrombocytopenia. New Engl J Med 2019;381(10):945–55.
Turner J, Parsi M, Badireddy M. Anemia. [Updated 2020 Sep 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK499994/
Lala V, Goyal A, Bansal P, et al. Liver Function Tests. [Updated 2020 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482489/
Jawaid A. Haematological causes of thrombocytopenia in children at Aga Khan University Hospital, Karachi. J Pak Med Assoc 2015;65(4):347–59.
Adly AA, Ragab IA, Ismail EA, Farahat MM. Evaluation of the immature platelet fraction in the diagnosis and prognosis of childhood immune thrombocytopenia. Platelets. 2015;26(7):645–50.
Bhushan R, Agarwal K, Garg J. Acute lymphoblastic leukemia with normal platelet count. Oncol J India 2017;1(2):43–5.
Kakaje A, Alhalabi MM, Ghareeb A, Karam B, Mansour B, Zahra B. et al. Rates and trends of childhood acute lymphoblastic leukaemia: an epidemiology study. Sci Rep 2020;10(1): 6756.
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