PERIPHERAL BLOOD COUNT RECOVERY TIME COURSE DURING INDUCTION TREATMENT FOR ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILDREN

Monya Abdullah Yahya El-Zine; Rahma Hamayun; Abdulrahman M Alhadi; Maged Ali Amer Ali; Hassan Abdulwahab Al-Shamahy

doi:10.22270/ujpr.v9i3.1110

Monya Abdullah Yahya El-Zine Department of Histopathology, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Rahma Hamayun Department of Pharmacology, College of Medicine, Northern Border University Kingdom of Saudi Arabia.
Abdulrahman M Alhadi Department of Pediatrics, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Republic of Yemen.
Maged Ali Amer Ali Department of Neurosurgery, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Hassan Abdulwahab Al-Shamahy Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University. Basic Sciences, Faculty of Dentistry, Sana’a University, Republic of Yemen.

10.22270/ujpr.v9i3.1110

Keywords:

Acute Lymphoblastic Leukemia (ALL), children, induction chemotherapy, peripheral blood count, Sana’a city, Yemen

Abstract

Background: In recent years, the survival rate of pediatric ALL patients has increased to almost 90%, particularly for individuals with favorable prognoses. This success is mostly attributable to the use of risk-adapted medication, enhanced supportive care, and adjustments to therapy based on each patient's unique pharmacodynamics and pharmacogenomics. This research investigates ALL patients' response to induction chemotherapy, focusing on changes in peripheral blood cell counts and hematological markers, to predict therapeutic outcomes and provide a practical prognostic parameter.

Methods: This study involved 100 under 15-year-old patients with newly diagnosed ALL treated in pediatric leukemia units at Kuwait Hospital, Sana'a. Blood markers were collected and analyzed using Epi Info statistical program version 6. The study followed the French, American, and British classifications of pediatric leukemia. Participants were informed of the study's goals and advantages, and their participation was optional.

Results: The majority of patients were aged 5-9 years, with a mean age of 6.9 years. Hemoglobin levels were measured before and after treatment, with the mean level being 8.8 mg/dL before and 10.8 mg/dL after treatment. Severe anemia was reported in 10% of patients before treatment and decreased to 2% after treatment. PCV levels were also measured before and after treatment, with the mean PCV level being below normal in 66% of patients before induction chemotherapy but improving to 20% after treatment. The mean RBC count before treatment was 2.9 cells × 10⁶/μl, but improved to 3.8 cells × 10⁶/μl after induction chemotherapy. The study found that over 50% of patients had iron deficiency anemia before and after induction chemotherapy, with a mean neutrophil percentage of 18.2%, lymphocyte percentage of 73.7%, monocyte percentage of 3.8%, and eosinophil percentage of 0.85%.

Conclusions: The study reveals that blood cell parameters replenish at different rates during induction chemotherapy, resulting in rapid platelet and slow neutrophil recovery. Changes in blood markers during induction may be prognostic.