Clinicohaematological Study of Leukaemias at a Tertiary Care Centre, Vindhya Region of India: A Cross-sectional Study

Abstract

Introduction: Leukaemia is characterised by widespread proliferation of leucocytes and their precursors in the body tissues and is usually associated with qualitative and quantitative changes in circulating white blood cells. The global burden of leukaemia is increasing. Aim: To study the morphology of leukaemia from Peripheral Blood Smears (PBS) and/or bone marrow smears and evaluate the clinical and haematological profile of leukaemia patients. Materials and Methods: This prospective observational study was conducted in a Tertiary Care Centre of the Vindhya region, in the Department of Pathology at Shyam Shah Medical College, Rewa, Madhya Pradesh, India. The study was carried out over a period of one year, from June 2019 to June 2020. A total of 90 newly diagnosed cases of all types of leukaemia during the study period. Detailed history, physical examination, complete blood counts, and bone marrow examinations were performed to confirm the diagnosis. Cytochemistry was used for the diagnosis and classification of acute leukaemia according to the French-American-British (FAB) classification. The data was compiled and analysed using appropriate statistical methods, and the mean was described with Standard Deviation (SD). Statistical significance was assessed using Analysis of Variance (ANOVA) test conducted with Statistical Package for Social Sciences (SPSS) version 22.0. Results: The study included 90 cases of all types of leukaemia, with a mean age of 36.5±22.5 years. There was a male preponderance in the study, with 65 (72.2%) males and 25 (27.8%) females, resulting in a male-to-female ratio of 2.6:1. Chronic Myeloid Leukaemia (CML) was the most common malignancy, accounting for total 40 (44.4%) cases. Non specific symptoms such as fever in 50 (55.6%), weight loss 49 (54.4%), and loss of appetite 42 (46.7%) cases were the most common symptoms across all types of leukaemia. Acute leukaemia also presented with leukopenia and normal leucocyte counts, while chronic leukaemia mostly showed markedly elevated Total Leucocyte Count (TLC) with a mean count of 1,30,912±63,792 per mm3. Conclusion: Light microscopic features of peripheral smear and bone marrow examination still play an important role in the diagnosis of leukaemia, especially in resource-poor health centres lacking immunotyping and cytogenetics.