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Tumor Discovery

ORIGINAL RESEARCH ARTICLE
Clinicohematological profile and

immunophenotypic patterns of childhood acute
leukemia: Prognostic correlation

1
Anju Khairwa * , Mrinalini Kotru 1 , Pooja Dewan 2 , and Swati Jain 1
1 Departments of Pathology, University College of Medical Science and GTB Hospital, New Delhi, India
2 Department of Pediatrics, University College of Medical Science and GTB Hospital, New Delhi, India

Abstract
Acute leukemia (AL) presents a heterogeneous molecular profile, requiring
precise diagnostic categorization and subcategorization. The present study aims
to estimate the clinicohematological profile and immunophenotypic pattern of
childhood AL while conducting prognostic assessments. This cross-sectional study
analyzed a total of 68 samples of AL collected from January 2019 to June 2021. The
male-to-female ratio was 4.6:1, with a mean age of 6.6 ± 3.4 years. Total leukocyte
count (TLC) was significantly increased in all types of AL (P = 0.03). The median
value (interquartile range) of TLC (×10 /dL) was 8,450 (4,100 – 27,950), with blast
6
counts in peripheral smears at 59 (24 – 80), and in bone marrow aspirates (BMAs) at
95 (75 – 98). There was a significant association (P < 0.001) and a strong association
(C = 0.9110) between the morphology of BMA with immunophenotype. Based on
*Corresponding author: immunophenotype, AL was categorized into four groups: B-cell acute lymphoblastic
Anju Khairwa
(akhairwa@ucms.ac.in) leukemia (B-ALL) (51.5%), T-cell acute lymphoblastic leukemia (T-ALL) (10.3%), AML
(22%), and mixed phenotype AL (MPAL) (16.2%). Furthermore, eight subgroups
Citation: Khairwa A, were identified: B lineage, Ia-Common-B-ALL (88.6%) and Ib-Pre-B-ALL (11.4%);
Kotru M, Dewan P, Jain S.
Clinicohematological profile and T-lineage, IIa-Cortical T-ALL (71.4%) and IIb-Pre-T-ALL (28.6%); AML subgroups,
immunophenotypic patterns IIIa-M2 (73.93%) and III-M4 (26.7%); and MPAL subgroups, IVa-aberrant expression of
of childhood acute leukemia: myeloid antigens in B-ALL (90.9%), and IVb-aberrant expression of lymphoid markers
Prognostic correlation. Tumor
Discov. 2024;3(2):2545. in AML (9.1%). A poor prognostic immunophenotype (T-ALL, AML) was significantly
doi: 10.36922/td.2545 (P = 0.023) more prevalent in deceased patients with AL. The highest mortality
Received: December 26, 2023 rate was observed in AML (86.4%), followed by T-ALL (57.2%). The most common
immunophenotype observed was Common-B-ALL in childhood AL, and a poor
Accepted: February 28, 2024
prognostic immunophenotype (T-ALL and AML) with the highest mortality rate was
Published Online: June 27, 2024 found in AML. Thus, knowledge about clinicohematological and immunophenotypic
Copyright: © 2024 Author(s). patterns will aid in patient management.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: Immunophenotype; Aberrant; Acute leukemia; Flow cytometry; Children
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited.
1. Introduction
Publisher’s Note: AccScience
Publishing remains neutral with Childhood acute leukemia (AL), specifically acute lymphoblastic leukemia (ALL),
regard to jurisdictional claims in 1
published maps and institutional is the most common malignancy observed in children. Various classifications of AL
affiliations. have been introduced over time by literature and the World Health Organization

Volume 3 Issue 2 (2024) 1 doi: 10.36922/td.2545