PROSPECTIVE STUDY OF CLINICAL PRESENTATION, DIAGNOSTIC PROCESS, TREATMENT AND INDUCTION OUTCOME; ONE YEAR EXPERIENCE IN PAEDIATRIC ACUTE MYELOID LEUKEMIA (AML).
Abstract
Introduction: Leukemias constitute one third of all paediatric cancers with myeloid neoplasms constituting about 20% of childhood leukemias.
Objective: To study the clinical features of pediatric Acute Myeloid Leukemia (AML) at presentation and to evaluate impact of these features on outcome.
Methods: It was a Cross-Sectional study conducted at The Children’s Hospital, Lahore from January 2022 to December 2023. The participants included 103 cases of AML diagnosed on bone marrow biopsy and flowcytometry, selected through consecutive convenience sampling. Data was analyzed through SPSS version 20.
Results: Among 103 patients, ninety-three received treatment. The mean age of presentation was 6.9 ±4.5 years and 72.1% were males. The common presenting feature was fever (92%) followed by pallor (64%). Majority of the patients (46%) had initial WBC count of 50,000-100,000/µl. The mean hemoglobin was 6g/dl and the mean platelet count was 14x109/L. Signs and symptoms involving central nervous system were observed in five patients and all were found to have hyperleukocytosis at presentation. The most common FAB subtype was M2(36%) followed by M4(15.5%), M5(12%) and M7(6.8%). Induction mortality rate was 53% and most common cause of death was septic shock. Among rest of the patients, remission rate after first induction was 74%.
Conclusion: Pediatric AML presented with fever, cytopenias, and hyperleukocytosis, with FAB M2 being the most prevalent subtype. While a substantial proportion of patients achieved remission after initial induction, the considerable induction-related mortality, largely attributable to sepsis, emphasizes the need to enhance supportive management and infection prevention strategies to improve survival outcomes.
