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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2018; 39(03): 307-311
DOI: 10.4103/ijmpo.ijmpo_10_17
Original Article

Profile of Acute Lymphoblastic Leukemia in Children Under 2 Years of Age

Anoop Cherungonath
Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
L Appaji
Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
M Padma
Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
BS Arunakumari
Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
AR Arunkumar
Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
T Avinash
Department of Pediatric Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
CR Vijay
Department of Epidemiology and Biostatistics, Kidwai Cancer Institute, Bengaluru, Karnataka, India
,
DS Madhumati
Department of Pathology, Kidwai Cancer Institute, Bengaluru, Karnataka, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Context: Acute lymphoblastic leukemia (ALL) shows substantial differences in clinical and laboratory features and treatment responsiveness in different subgroups. Pediatric ALL <2 years is associated with worse outcome. Infantile ALL is characterized by high white blood cell (WBC) counts, bulky extramedullary disease, translocations of 11q23 locus. There is paucity of data on ALL under 2 years of age. Aims: This study aims to analyze clinical, hematological, biochemical, immunophenotypical parameters, and treatment responsiveness of ALL under 2 years. Settings and Designs: It is a retrospective data analysis conducted at a Tertiary Care Cancer Centre in South India. The study population includes all pediatric ALL, registered at this institute during January 2009 to December 2013, who were under 2 years at the time of presentation. Materials and Methods: There were 122 cases of ALL under 2 years of age of whom 48 refused treatment, and four were lost to follow-up. Thus, 70 cases are eligible for analysis. Details on clinical, hematological, biochemical, radiological, immunophenotypical, and cytogenetic features were collected from case records, hospital cancer registry, and analysis done using SPSS version 20. Kaplan–Meier curves plotted for survival analysis. Results:: Male:female ratio was 1.26:1 (infants - 1:1; 1–2 years group - 1.3:1). The most common clinical features were hepatomegaly (95%) and fever (89%). Hemoglobin level >11 gm% was seen in 12%, WBC counts above 50,000 in 26% and platelets below 20,000 in 20%. Elevated lactate dehydrogenase presents in 64% and uric acid in 12%. Immunophenotype done in 44 children; precursor-B ALL-41, precursor-T ALL-3. Central nervous system -positive disease and 11q23 translocation were noted in one infant each. Conclusions: Infants with ALL are associated with poor prognosis. Children in the 1–2 years are associated with significantly better outcome. WBC counts >50,000 are associated with poor prognosis among infants. Treatment refusal/abandonment rate is 43% in the study population which is comparable to that in literature.

Keywords

Acute lymphoblastic leukemia - infantile - prognosis - survival


Publication History

Article published online:
17 June 2021

© 2018. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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