Abstract Ref Number = APCP928
HYPERLEUKOCYTOSIS IN CHILDHOOD LEUKEMIA AT M DJAMIL HOSPITAL PADANG
Diska Yulia Trisiana,Amirah Zatil Izzah,Firman Arbi
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Andalas
Background : Hyperleukocytosis is defined as peripheral leukocyte count exceeding 100,000 per microlitre in patient affected by leukemia. Complications of hyperleukocytosis are tumor lysis syndrome, leukostasis and DIC that can lead to death. As hyperlekocytosis is associated with early morbidity and mortality, any patient presenting with a leukocyte count greater than 50,000/mm3 should be evaluated closely for clinical signs and symptoms of complication. This study aims to describe characteristics and outcome of hyperleukocytosis patient in M. Djamil Hospital Padang.
Material : The descriptive analytic study of childhood leukemia with an initial leukocyte count >50.000/mm3 data collected from medical records between October 2015 and March 2018 at M. Djamil Hospital Padang. Data included age at diagnosis, sex, complete blood count, routine blood chemistry values, symptomps of leukostasis, and outcome of the patients. Data were analyzed by using independent sample T test and Pearson correlation, significance level p value < 0,05.
Results : There were 33 (24%) patients with hyperleukocytosis of 137 children with leukemia. Mostly patient diagnosis as ALL (66,7%), boys (66,7%), aged 2-9 years (57,6%), leukocyte count >50.000-100.000/mm3 39,4%, hemoglobin <6 g/dl (45,5%), thrombocytopenia 20000-50000/mm3 (42,4%), hepatomegaly (87,9%) and splenomegaly (78,8%). Majority of patients were asymptomatic (60,6%). Twelve patients (36,4%) died during hyperleukocytosis, 13 patients (39,3%) had chemoterapy. Of 13 patients who had chemotherapy, 9 patients (69,2%) got remission after induction phase. There was significant statistic relationship between leukocyte count with level of uric acid and creatinine serum, and glomerular filtration rate (p<0.005).
Conclusions : Almost a quarter of patients had hyperleukocytosis, mostly diagnose as ALL. Majority of patients had severe anemia and moderate thrombocytopenia. Not all of patients had hepatosplenomegaly. Death was quite high during hyperleukocytosis. More than a half patients received chemotherapy got induction remission. Leukocyte count was in correlation with level of uric acid and creatinine serum and glomerular filtration rate.
Keywords: Hyperleukocytosis Leukemia Characteristics Outcome