EXTRAMEDULLARY SYMPTOMS AT THE INITIAL PRESENTATION OF ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILDREN

B. Irfan, A. Zhailaubaeva, G. Tashenova, A. Tulebayeva, G. Bulabaeva
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Abstract

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy with variety of nonspecific symptoms that may present with signs and symptoms related to extramedullary involvement, therefore, leads to delayed diagnosis of ALL in children. Aim: This study aims to determine the prevalence of extramedullary manifestations at the initial presentation of acute lymphoblastic leukemia in children. Method: This is a retrospective, cross-sectional study assessing medical records of 73 patient newly diagnosed (ALL) at Almaty Scientific center of pediatrics and surgery during-2020. The children had a mean age of 6.9 ±4.27 years. The female and male patients made 46 (63 %) and 27(37 %) respectively. children with acute lymphoblastic disease were classified into two subtypes (B-cell ALL and T-cell ALL) according to the WHO classification. Data earned from the study were enrolled within a directory also statistical analysis was done by applying the software (SPSS) version 26.0. Categorical variables resembled using the chi-square test or Fisher’s exact test, as appropriate. Result: In this study, the most common extramedullary initial signs and symptoms of ALL were related to hepatic system 49 (67.1 %) and gastrointestinal symptom 43 (58.9%).The additional extramedullary presentations of ALL in order of frequency include; lymphadenopathy 20 (27.4%) , musculoskeletal system 19 (26%) urinary system 9 (12.3 %), Respiratory 9 (12.3 %) , Neurological system 5 (6.8%) orbital presentation 3 (4.1%), neurologic signs 8 (9%%), pericardial involvement 1 (1.4%), and the other miscellaneous presentations 3 (4.1%).Conclusion: This study showed that a significant number of ALL patients present with variety of extramedullary symptoms that pediatrician must become familiar with those to detect some atypical cases of leukemia early on. And increase the probable chance of survival by early detection.
儿童急性淋巴细胞白血病初发时的髓外症状
急性淋巴细胞白血病(ALL)是最常见的儿童恶性肿瘤,有各种非特异性症状,可能表现出与髓外受累有关的体征和症状,因此导致儿童ALL的诊断延迟。目的:本研究旨在确定儿童急性淋巴细胞白血病初始表现时髓外表现的患病率。方法:这是一项回顾性横断面研究,评估了阿拉木图儿科和外科科学中心2020年期间73名新诊断(ALL)患者的医疗记录。这些儿童的平均年龄为6.9±4.27岁。女性患者46例(63%),男性患者27例(37%)。根据世界卫生组织的分类,急性淋巴细胞性疾病的儿童被分为两种亚型(B细胞ALL和T细胞ALL)。从研究中获得的数据被纳入一个目录中,并通过应用软件(SPSS)版本26.0进行统计分析。分类变量类似于使用卡方检验或Fisher精确检验,视情况而定。结果:在本研究中,ALL最常见的髓外初始体征和症状与肝系统49例(67.1%)和胃肠道症状43例(58.9%)有关;淋巴结病20例(27.4%),肌肉骨骼系统19例(26%),泌尿系统9例(12.3%),呼吸道9例(1230%),神经系统5例(6.8%),眼眶表现3例(4.1%),神经病学体征8例(9%),心包受累1例(1.4%),结论:本研究表明,大量ALL患者表现出各种髓外症状,儿科医生必须熟悉这些症状,才能早期发现一些非典型白血病病例,并通过早期发现增加生存的可能机会。
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