RETICULOCYTE COUNT AS A PREDICTOR OF DETECTING HAEMATOPOIETIC RECOVERY ON INDUCTION THERAPY IN ACUTELYMPHOBLASTIC LEUKEMIA
Abstract
INTRODUCTION: After diagnosis, chemotherapy is the main stay of treatment in ALL. Approximately 75% of children who presents with ALL had significant anemia with hemoglobin (Hb) less than 10g/dl; currently anemia remains one of the most common complications of cancer and plays a critical role in the quality of life of these children.
OBJECTIVE: To determine the accuracy of reticulocyte count in detecting hematopoietic recovery on induction therapy in acute lymphoblastic leukemia confirmed by bone marrow examination.
METHODOLOGY: This was a cross sectional descriptive study of six months on 119 patients. An informed written consent was taken from parents or relatives of the patients. On day 07 of the end of 4th phase of chemotherapy, 2ml of blood were collected from them in the EDTA tube, absolute neutrophilic count were obtained by using Sysmex analyzer and supra vital stain of unfixed RBCs were done with new methylene blue by mixing of 100ul of patient blood with the 100ul of methylene blue, after incubation for 15-20 minutes at 370C the dilution was remixed and a wedge smear were performed to obtain reticulocyte count after which bone marrow biopsy were performed to check for accuracy of reticulocyte count.
RESULTS: In this study, 119 patients were observed, in which Male to female ratio was 2.84:1. Average age was 9.04 years ± 5.4 SD. Accuracy of reticulocyte count in detecting hematopoietic recovery in the study was 99 (83.19%).
CONCLUSION: Reticulocyte count is the appropriate predictor of hematopoietic recovery in patients on induction therapy in acute lymphoblastic leukemia.
KEY WORDS: Reticulocyte count, Acute lymphoblastic leukemia, Hematopoietic recovery, Induction therapy.
References
Olu-EAN, Ohanaka CE. Peripheral lymphadenopathy in Nigerian adults. J Pak Med Assoc 2006; 56: 405-8.
Alison M, Friedmann. Evaluation and management of lymphadenopathy in children. Pediatr Rev 2008; 29: 53-60.
Mohammad A, Naseer A, Ihsanullah, Iqbal MJ. Cervical lymphadadenopathy: Diagnostic approach. JPMI 2006; 20: 374-8.
Memon W, Samad A, Sheikh GM. Hodgkin’s lymphoma in cervical lymphadenopathy. Pak J Med Sci 2008; 24: 118-21.
Khan R, Haris SH, Verma AK, Syed A. Cerviccal lymphadeopathy: scrofula revisited. The JLO 2009; 123: 764-7.
Nomani K, Kazi BM. Frequency of tuberculous cervical lymphadenitis detection at a single laboratory in Islamabad. J Coll Physicians Surg Pak 2007; 17: 410-2.
Sheikh SM, Baloch I, Bhatti Y. An audit of 200 cases of cervical lymphadenopathy. Medical Channel 2010; 16: 85-7.
Byung MK, Eun KI. Sonographically guided core needle biopsy of cervical lymphadenopathy in patients without known malignancy. J Ultraosound Med 2007; 26: 585-91.
Cole AS, Trotter MI. Follicular lymphoma presenting as mumps, with persistent cervical lymphadenopathy. JLO 2007; 121: 501-2.
Dangore SB, Degwellar SS. Evaluation of the efficacy of color Doppler ultrasound in diagnosis of cervical lymphadenopathy. Dentomaxillo Facial Radiol 2008; 37: 205-12.
Ann DK, Anil TA, David KW. Yenng, malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 2007; 245: 806-13.
Jamal A, Khatoon S, Junejo A. Frequency of Hodgkin’s lymphoma in patients with cervical lymphadenopathy presenting in public sector hospital in Pakistan. JLUMHS 2008; 6: 173-6.
Dandapat MC. Peripheral lymph node tuberculosis, a review of 80 cases. Br. J Surg 1990; 11: 911-2.
Dolberg OT. Extrapulmonary tuberculosis in an immigrant society,clinical and demographic aspects of 92 cases. Rev Infect Dis 1991; 13: 177-9.
Rieder L. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis 1990; 141: 347-51.
Jha BC, Dass A, Nagarkar NM, Gupta R, Singhal S. Cervical tuberculous lymphadenopathy: changing clinical pattern and concepts in management. Postgrad Med J 2001; 77: 185-7.
Siddiqui FG, Ahmed Q. Cervical lymphadenopathy. J Surg Pak 2002; 7: 23-5.
Bezabih M, Mariam DW, Selassie SG. Fine needle aspiration cytology of suspected tuberculous lymphadenitis. Cytopathol 2002; 13: 284-90.
Pandit AA, Candes FP, Khubchandani SR. Fine needle aspiration cytology of lymph nodes. J Postgrad Med 1987; 33: 134-9.
Maharjan M. Incidence of tuberculosis in enlarged neck nodes, our experience. Kathmandu University Med J 2009; 7: 54-8.
Weiler Z, Nelly P, Baruchin AM, Oren S. Diagnosis and treatment of cervical tuberculous lymphadenitis. J Oral Maxillofac Surg. 2000; 58: 477-81.
Al-Mulhim AS, Al-Ghamdi AM, AL-Marzooq YM, Hashish HM, Mohammad HA, Ali AM, et al. The role of the needle aspiration cytology and imprint cytology in cervical lymphadenopathy. Saudi Med J 2004; 25: 862-5.
