AN EXPERIENCE WITH SIXTY CASES OF HAEMATOLOGICAL MALIGNANCIES; A CLINICO HAEMATOLOGICAL CORRELATION
AbstractBackground: Haematological malignancies are not uncommon in our area. Due to inadequate diagnostic facilities and lack of health education they are diagnosed at an advanced stage when treatment is either impossible or very difficult. In our study, sixty patients with haematological malignancies were studied from 1-1-1999 to 1-1-2001, at Ayub Teaching Hospital, Abbottabad. Methods: Patients were interviewed in detail, a thorough physical examination and blood tests including haemoglobin estimation, total and differential leukocyte count, platelets count, reticulocyte count and blood film examination was done on each patient. Bone marrow examination for routine giemsa staining and cytochemistry was also done in each case. Trephine biopsy was done in selected cases. Results: About 35.9% patients had acute myeloid leukemia, while 19.15% patients had acute lymphoblastic leukemia. Non Hodgkin’s lymphoma was seen in 15.39% cases. Among chronic leukemias, chronic lymphocytic leukemia outnumbered chronic myeloid leukemia (13.91% against 10.76%). Multiple myeloma was seen in 4.61% patients while a single patient had Hodgkin’s disease. Male to female ratio in haematological malignancies was 1.4:1 and majority of the patients (66.66) belonged to two districts (i.e. Mansehra and Abbottabad). Low grade fever, progressive pallor, weakness and body aches were the commonest symptoms (70% cases) while pallor was the frequently observed sign. Medium age for acute myeloid and acute lymphoblastic leukemia was 26 years and 7 years respectively. For chronic myeloid and chronic lymphocytic leukemia it was 22 years and 56 years respectively. In case of non Hodgkin’s lymphoma it was 22.5 years. Conclusion: In our study acute myeloid leukemia was the commonest type of haematological malignancy. Males were affected more than the females. Majority of the patients belonged to districts Mansehra and Abbottabad. Non specific symptoms like low grade fever, progressive pallor and bodyaches were the commonest symptoms while pallor was the most frequently observed sign.Key Words: Haematological malignancy, Clinicohaematological correlation, Leukemia
Robert IH, Samuel EL, Thomas PS. Blood, principles and practice of hematology. Philadelphia JB Lippincott Company 1995; pp.457-74.
Hoffbrand AV, Lewis SM, Tudenham EGD. Postgraduate haematology. Butterworth Heinnemann, 1999; pp.372-443.
Bayerl MG, Rakozy CK, Mohamed AN, Long M. Eitender D, Palutke M. Blest Natural Killer Cell Lymphoma/Leukemia. A report of seven cases. Am J Clin Path. 2002;117(1):41-50.
Hans PC, Finn WG, Singleton PT, Schnitzer B, Ross CW. Usefulness of anti-CD 117 in the flow cytometric analysis of acute leukemia. Am J Clin Path. 2002;117(2):301-5.
Coiffier B, Lepage E. CHOP chemotherapy plus ritalimas compared with CHOP alone in elderly patients with diffuse large Beta cell lymphome. N Engl J Med 2002; 546(4):235-42.
Hoelzer D, Gale RP. Acute lymphoblastic leukemia in adults: recent progress, future directions. Semin Hematol 1987;24:27-31.
Cooke JV. Incidence of acute leukemia in children. JAMA 1942;119:547-9.
Young JL, Ries LG, Silverberg E. Cancer incidence, survival and mortality for children younger than age 15 years.
William WJ, Butler F, Erslow AJ, Lichtman MA. Hematology. New York McGraw Hill Book Company, 1991; pp.981-88.
Turesson I, Zattervell O, Cuzkk J. Comparison of trends in the incidence of multiple myeloma in malrow, Sweden and other countries, 1950-1979. N Engl J Med 1984;310-421.
Correa P, O’conor GT. Epidemiologic patterns of Hodgkin’s disease. Intl J Cancer 1971;8:192-7.
Robert IH, Samuel EL, Thomas PS. Blood, principles and practice of hematology. Philadelphia JB Lippincott Company 1995; pp.851-84.
Ahmad M, Khan AH and Mansoor A. The pattern of malignant tumor in northern Pakistan. J Pak Med Assoc 1991;41:270-4.
Hassan K, Qureshi M, Shafi S, Ikram N, Akhtar MJ. Acute myeloid leukemia-FAB classification and its correlation with clinico-haematological features. J Pak Med Assoc 1993;43(10):200-10.
Savage DG, Szydlo RM, Goldman JM. Clinical features at diagnosis in 430 patients with chronic myeloid leukemia seen at a referral centre over a 16 year period. Br J Haematol 1997;96:111-116.
Zahid M, Khalid A, Ahmad ZD, Aziz Z. Acute leukemias of childhood: A retrospective analysis of 62 cases. J Pak Med Assoc 1996;46(7):147-49.
Hassan K, Bukhari KP, Zafar A, Malik MZK, Akhtar MJ. Acute leukemia in children-French-American-British (FAB) classification and its relation to clinical features. J Pak Med Assoc 1992;42:29-33.
Ahmad M, Khan AH, Mansoor A, Khan MA, Saud S. Non-Hodgkin’s lymphoma-clinicopathological pattern. J Pak Med Assoc 1992;42:205-08.
Vallespi TT, Montserrat E, Sanz MA. Chronic lymphocytic leukaemia: Prognostic value of lymphocyte morphological subtypes. A multivariate survival analysis in 146 patients. Br J Haematol 1991;77:478-85.
Pasqualetti P, Festuccia V, Acitelli P, Collacciani A, Giuski A, Casale P. Tobacco smoking and risk of haematological manignancies in adults: A case-control study. Br J Haematol 1997;97:659-62.