The Prognostic Significance of HbF in Childhood Haematological Malignancies.

Abstract

The degree of increase infoetal haemoglobin(HbF) synthesis in haematological malignancies may be associated with the degree of malignancy. The aim of the present study was to quantify HbF levels in various childhood haematological malignancies and also, to ascertain its prognostic significance by comparing the results with the already established standard prognostic factors. Newly diagnosed cases of haematological malignancies in the paediatric age group were included in the study. HbF levels were estimated in each case of the study group along with HbF levels of control group comprising healthy children of same age group. The estimation was done by HPLC and Modified Betke's method. 50 cases of newly diagnosed haematological malignancies were studied out of which most of the cases were of acute lymphoblastic leukaemia (ALL) [n=30(60%)] followed by acute myeloid leukaemia (AML) [n=8(16%)], Hodgkin's lymphoma [n=7(14%)], non-Hodgkin's lymphoma [n=5(10%)]. Raised HbF levels were found in 43.3% cases of ALL (13/30) and 37.5% cases of AML (3/8). No significant rise in HbF level was found in cases of lymphomas. There was correlation between raised HbF level and poor prognostic factors in cases of ALL but no such correlation was found in cases of AML. HbF levels are often elevated in childhood leukaemias as compared to childhood lymphomas. Thus, the concentration of HbF in acute childhood leukaemia may be considered as a prognostic factor.