[1539] Distinctive Impacts of Different Lineage of Acute Leukemia on Peripheral Blood and Demographic Parameters in Pediatric Patients

Yao X Schmidt, Xiayuan Liang. University of Colorado at Denver, Aurora, CO; Children's Hospital Colorado, Aurora, CO

Background: Acute leukemia is the most common neoplasm in childhood. Clinically, patients often present with anemia and thrombocytopenia as the result of blast proliferation in the bone marrow. However, the level of cytopenia varies immensely among patients. To assess the distinctive impact of cytopenia by different lineages of leukemia, we analyzed peripheral blood parameters and the demographic factors among different lineages of acute leukemia.
Design: 301 cases of consecutive newly diagnosed childhood (≤ 18 years) acute leukemia at Children's Hospital Colorado from 2006 to 2011 were reviewed. 23 of them were T-ALL, 227 were B-ALL, and 51 were AML. The age, sex, hyperleukocytosis (≥ 100,000/mm3), Hb, Hct, moderate to severe thrombocytopenia (platelets: <100,000/mm3), and CSF involvement were compared among the group of patients with B-ALL, T-ALL, and AML. The statistical significance of the differences was calculated by Fisher exact test, Chi square test, and t-test.
Results: See the following table.

	T-ALL	B-ALL	AML		P Value
	(n=23)	(n=227)	(n=51)	T-ALL vs B-ALL	T-ALL vs AML	B-ALL vs AML
Mean age (y) (Range)	10.3 (0.92-18)	5.7 (0-18)	9.6 (0.08-18)	<0.0001	0.422	<0.0001
Male: Female	19:4 (4.75:1)	121:106 (1.14:1)	33:18 (1.83:1)	0.0076	0.1706	0.1854
WBS (>100,000/mm3)	13/23 (56.5%)	21/227 (7.3%)	6/49 (12.2%)	0.0001	0.0002	0.7079
Mean Hb (g/dL) (range)	9.9 (4-14.8)	8.4 (3.1-13.8)	9.0 (3-17.7)	0.017	0.253	0.137
Mean Hct (%) (range)	30.4 (11-46.7)	24.2 (8.5-42.5)	26.3 (4.0-48)	0.0004	0.074	0.083
Platelet (<100,000/mm3)	18/23 (78.3%)	204/225 (90.7%)	37/49 (75.5%)	0.1355	1.0000	0.0067
CSF + (%)	8/22 (36.4%)	54/219 (24.7%)	27/48 (56.3%)	0.3464	0.1975	0.0001

Conclusions: First, B-ALL shows more negative effects on the production of red blood cell and platelet than T-ALL and AML, suggesting that B-cell associated cytokines may decrease erythropoietin and megakaryocyte production more than T-ALL and AML. Second, high frequency of hyperleukocytosis, older patients, and male predominance appear to be lineage related (T-ALL > AML > B-ALL) in pediatric acute leukemia. Third, higher frequency of CSF involvement in AML may be at least partially responsible for poorer prognosis of AML than ALL.
Category: Hematopathology

Wednesday, March 21, 2012 1:00 PM

Poster Session VI # 235, Wednesday Afternoon