Study of Clinico-hematological and Immunophenotypic Profile in Adult Patients with Acute Lymphoblastic Leukemia in Eastern India

Abstract

Aims: To study clinical, hematological and immunophenotypic profile of adult patients with acute lymphoblastic leukemia (ALL) in a tertiary care centre of eastern India. Study Design: Cross-sectional study Place and Duration of Study: Postgraduate Department of Medicine and Department of Clinical Hematology, SCB Medical College and Hospital, Cuttack, Odisha, India between August 2011 and July 2012. Methodology: Sixty naïve consecutive cases of adult ALL were taken into this study. Secondary and relapsed cases of ALL were excluded. Along with clinical evaluation, full blood count, bone marrow aspiration study, immunophenotyping by flow cytometer was done in all of the cases. Results: Patients between 15 to 24 years constituted 58.3% of cases in the study. Mean age was 26.58 years and median age (50th percentile) was 22 years. Pallor (96.7%) and fever (81.3%) were the most common presentations. Bleeding manifestations and fever were significantly associated with B-ALL (P<.01). Lymphadenopathy and mediastinal mass were found significantly higher in patients with T-ALL(P<.01).On bone marrow morphology, FAB L1 was found in 38.3% and L-2 was seen in 61.7% of cases. Myeloperoxidase stain was negative in all cases.68.3% cases came out as B-ALL and 31.7% as T-ALL after immunophenotyping. CD19 and cytoplasmic CD79a were the most commonly found to be positive in patients with B-ALL whereas CD7 and cytoplasmic CD3 were the most common antigens expressed in those with T-ALL. Anti-MPO was negative in all of the cases. Aberrant myeloid expression was also found in 21.7% cases. There was no significant association of aberrant myeloid expression with B or T-cell immunophenotype (P=.32). Conclusion: Clinico-hematological and immunophenotypic profile of ALL patients in this region were almost similar with the reports published from other parts of India but there were a few differences from the Western data. This, however, needs further work from this region of India.