FREQUENCY OF CENTRAL NERVOUS SYSTEM INVOLVEMENT IN ACUTE LYMPHOBLASTIC LEUKEMIA AT PRESENTATION
Keywords:
Acute Lymphoblastic Leukemia, Bone Marrow, Central Nervous System, Cerebrospinal FluidAbstract
Objective: To assess the frequency of central nervous system (CNS) involvement in childhood acute lymphoblastic
leukemia (ALL) at presentation.
Material and Method: This descriptive study was conducted on children below 17 years of age, over a period one
year from January 2008 to January 2009. A total of 50 newly diagnosed ALL patients from all over Khyber Pukhtunkhwa
were included in the study. Complete Blood Count and Bone Marrow findings of these patients were recorded and
lumbar puncture was performed to assess the cerebrospinal fluid for central Nervous System involvement. Data was
collected and statistically analyzed using soft ware SPSS 13.
Results: Out of these 50 newly diagnosed ALL patients, 33 were males and 17 were female with a M:F ratio of 1.9:1.
Two patients were found with nervous system involvement. L1 and L2 morphology was seen in 92% and 8% of
patients respectively. The prognostically favorable age group (1-10 years) had 6.5% L2 morphology compared with
10.5% in the prognostically unfavorable age group (above 10 years) indicating poor prognosis with increasing age.
The frequency of CNS involvement in ALL was found in 4 % of these children.
Conclusion: For better prognosis, cerebrospinal fluid (CSF) examination must be done in every ALL child to find CNS
involvement and initiate specific CNS directed therapy.
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