Dynamics of Laboratory and Clinical Parameters in the Prediction of Relapse in B Acute Lymphoblastic Leukemia

Abstract

Background: Acute lymphoblastic leukemia (ALL) is the most prevalent type of cancer in children, attacking the B and T cells of the immune system. B-cell malignancy is common in pediatric patients. Relapse of disease is the ultimate cause of poor survival in B-Acute lymphoblastic leukemia (B-ALL) and the biggest challenge to treat. With the availability of novel therapies, including targeted therapies, the survival of relapsed patients can be improved if it can be detected at its initial stage. Although many studies have identified risk factors associated with a high probability of relapse, there is no clear indicator that can indicate impending relapse in its initial stage. newlineObjectives: To study CBC parameters of Acute Lymphoblastic Leukemia (ALL) patients from diagnosis till either relapse or last follow-up. To study Clinical variables such as fever of unknown origin (FUO), unexpected weight loss, new lymphadenopathy or organomegaly, history of bleeding etc. from diagnosis till either relapse or last follow-up. To study other laboratory parameters of ALL patients from diagnosis till either relapse or last follow-up. To study the association between clinical, CBC and other laboratory parameters with immediate (within a month) relapse and overall survival. newlineMethod: In a prospective study, we included total 151 pediatric B-ALL patients with age and#8804;16 years. Among 151 patients, relapse patients were 51, while non relapse were 100. Clinical parameters, Complete blood count (CBC) and other laboratory parameters were studied. Clinical parameters and CBC parameters were studied and compared at different time points in patients with relapse i.e. diagnosis, 3-6 months before relapse and 1-3 months before relapse and at the time of relapse, while in non-relapse patients, time points studied were diagnosis and 2 years follow-up from initiation of therapy / last follow-up documented.