Clinico-Hematological Signature of Acute Leukemia: A Case-Control and Subtype-Based Analysis of Blood Cell Parameters

Zainab K.  Lafta; Alaa Shakir  Alnahi; Mazin S.  Salman

doi:10.51699/cajmns.v7i4.3349

Authors

Zainab K. Lafta College of health and medical technologies - Southern technical University
Alaa Shakir Alnahi College of health and medical technologies - Southern technical University
Mazin S. Salman Basrah medical technichal institute - Southern technical University

DOI:

https://doi.org/10.51699/cajmns.v7i4.3349

Keywords:

acute leukemia, complete blood count, hematological markers, AML, ALL, anemia, thrombocytopenia

Abstract

Background: Acute leukemia is an aggressive hematological malignancy characterized by clonal expansion of immature hematopoietic precursors with suppression of normal marrow activity. Primary lab parameters paradoxically, despite the need for next-generation sequencing (NGS) and advanced histopathologic classification to choose treatment options in leukaemia patients, blood count parameters still provide an essential first window into burden of disease, risk of marrow failure and clinical risk groups. The study aimed to investigate the hematological parameters of acute leukemia patients vs healthy controls and find out if blood cell parameters differ according to sex, age group or Leukemia sub type.

Methods: A total of 88 samples were used in a case-control study, consisting of 48 acute leukemia cases and 40 healthy controls (CD). Patients were those with acute lymphoblastic leukemia and acute myeloid leukemia. Blood samples prior to chemotherapy Blood was analyzed for complete blood count and differential leukocyte counts using the ADVIA 2120i Hematology System. The parameters studied were WBC, RBC, platelet count, Hb, HCT MCV and MCHC.

Results: patients and controls were matched for age, sex distribution. The median values of WBC, RBC, platelet count, Hb, HCT, MCV, MCH and MCHC were significantly lower in patients than controls (P<0.05) but the percentage of neutrophils and eosinophil was much higher while percentages of lymphocytes were much higher compared with controls. The difference was not significant for monocytes and basophils. Results of sex comparison, significant only for MCHC. An analysis stratified by diagnosis showed that WBC and platelet counts were substantially greater in AML than ALL (all p<0.001). When analysed according to age, Hb lower in older patients was the only significant difference.

Conclusions: Acute leukemia most often produced a recognizable hematologic picture characterized primarily by anemia, thrombocytopenia, reduced neutrophils and disorganized distribution of leukocyte output. The majority of blood parameters were not significantly affected by sex or age indicating that the abnormal hematological change is mainly determined by leukemic marrow disruption.

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