Bipsa Singh1 , Piyush Ranjan Sahoo2 , Swarupa Panda3 , Sudha Sethy4 , Bibhu Prasad Nayak5
BACKGROUND Acute leukaemias are one of the most common malignancies in children aged < 15 years, accounting for nearly one third of all paediatric malignancies. Fortunately, it is one of the curable malignancies in children and hence early diagnosis is of supreme priority. Flow cytometry has now become a standard tool for diagnosing and monitoring acute as well as chronic leukaemia. Immunophenotyping by flow cytometry enables accurate diagnosis, guides treatment, and enables risk stratification. METHODS This is a hospital based cross sectional study, carried out in the Paediatrics and Clinical Haematology wards, SCB Medical College & Hospital, Cuttack, from December 2017 to November 2019. All patients fulfilling inclusion criteria were included in the study. Demographic details, history and examination findings were recorded in all cases. Complete blood count, peripheral smear, CSF analysis, RFT, LFT, chest X ray, CT scan brain and chest, USG abdomen, microbiological investigations, bone marrow aspiration, immunophenotyping were done and documented in pre-structured proformas in all cases. RESULTS Among 209 acute leukaemia cases, ALL was the commonest (60.8 %) followed by AML (24.9 %). Among the B-ALL cases, Pre-B ALL patients had the majority (78.4 %) followed by T-ALL (12.4 %), Pro-B ALL (2.9 %), MPAL (1.9 %) and Mature B - ALL (< 1 %). Mean age was 6.81 years and SD ± 4.10. Male : female ratio among ALL patients was 1.78:1. Fever was the commonest symptom and hepatosplenomegaly, the commonest sign. CD13 and CD33 were the commonly co-expressed myeloid markers in all. CONCLUSIONS Immunophenotyping should be done in all cases of leukaemia, even in resource limited settings for accurate diagnosis, prognostication and tailoring of treatment. Presence of extra-medullary organ involvement, including CNS and kidneys, should be looked for carefully at the initial presentation.
