Erum Amir, Naila Tariq, Amir Sharif.
Frequency and Clinico - Pathological Profile of Patients with Leukaemia; Tertiary Care Centre Experience from JPMC Karachi.
Ann Jinnah Sindh Med Uni Jan ;3(1):33-6.

Objective: The aim of this study was to analyze the trends in the frequency rates of four major types of leukaemias and to .determine the clinico - pathological profile of the patients visited to the oncology department of a tertiary care centre in Karachi. Methodology: It is a retrospective, cross-sectional study conducted in the oncology and clinical pathology units of one of the largest tertiary care centres in Karachi, from January 2015 -December 2016. A total of 350 known cases of leukaemia were taken with confirmative diagnosis supported by bone marrow biopsy trephine, FISH, RT-PCR immunohistochemistry, cytogenetics and other base line investigations like CBC, LFTs, urea creatinine, LDH, ALP. Results: The present study reveals that 350 cases of leukaemia ranging between 15 and 60 years, were seen at the JPMC clinical pathology/ oncology unit. Acute leukaemia was more commonly found i.e. 218 (62.3%) than chronic leukaemia i.e. 132 (37.7%). The ratio of acute and chronic leukaemias was 1.7:1. Male:Female ratio was 2.3:1. Acute leukaemias were subdivided into 116 (33%) cases of ALL and 102 (29%) cases of AML. Chronic leukaemia was further subdivided into 108 (31%) cases of CML and 24 (7%) cases of CLL. Four cases were of Myeloproliferative Disorders with JAK2 mutations out of which three were of polycythemiavera and one case of essential thrombocytosis.Two cases of transformation from MPD to AML were seen.. The major presenting complaints were fever 78 %, general weakness 62%, bleeding diathesis 40%, shortness of breath 7% and weight loss 35%. The most common sites of bleeding were mucosal bleeds from nose, gums, gastrointestinal tract, and genito-urinary tract. Physical examination revealed splenomegaly 41%, lymphadenopathy 37%, hepatomegaly 32%. Anaemia was the most common finding affecting 259 patients (74 %). The mean haemoglobin was 7.2 g/dl (range 6.3-8.5) g/dl. TLC was 76.5x 10/l (range 44 to 140). The mean platelets count was 90x10/l. Conclusion: We concluded that the clinico-epidemiological features of adult leukaemias differ considerably from those seen in the developed world. In our study, the most common of all leukaemias was ALL 62.3%. In contrast, AML was reported to be the most prevalent acute leukaemia in the US. CLL was the least common accounting for 7% of all cases. The mean age of presentation was 61 years. CML was 4.3 times commoner than CLL with a younger age at presentation (median age was 30 years) in contrast to CLL. Key words: Leukaemias, acute lymphoblastic leukaemia, acute myeloblastic leukaemias, chronic lymphocytic leukaemia, chronic myeloid leukaemias

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