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

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. Peer Review History: Received 6 April 2024; Revised 10 May 2024; Accepted 25 June; Available online 15 July 2024 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com