PANCYTOPENIA AS INITIAL PRESENTATION OF ACUTE LYMPHOBLASTIC LEUKEMIA AND ITS ASSOCIATIONWITH BONE MARROWRESPONSE

Objective:The objective of this study is to determine the frequency of pancytopenia and bone marrow response to treatment of acute lymphoblastic leukemia. Materials And Methods:This is a cross sectional study carried out at Medical Oncology Department, Hayatabad Medical Complex, Peshawar. A total of 120 patients were included in the study. Venous blood sample was obtained from patients and sent to the laboratory of the hospital for assessment of red blood cells, white blood cells, and platelets. Reports were assessed and levels were noted. If levels were lower than normal, then patients were labeled as having pancytopenia was labeled.Patients were advised treatment i.e drug regimen including weekly intravenous vincristine, daunorubicin, weekly intrathecal methotrexate and daily dexamethosone for 4 weeks). After 4 weeks they underwent bone marrow aspiration. All samples were sent to the laboratory of the hospital for assessment of bone marrow response i.e M1 (less than 5% lymphoblasts), M2 (5% to 25% Lymphoblasts)& M3 (more than 25% Lymphoblasts). Results:Pancytopenia was recorded in 35 (29.16%) patients presenting with acute lymphoblastic leukemia. Out of these thirty-five patients, 21 (60%) were male and 14(40%) were female. Out the 21 males, 20 (95.24%)hadM1 responsewhile01(4.76%)patienthadM2response. Out of the14female patients,12(85.71 %)hadM1 response, 1(7.14 %) had M2 and 1(7.14%) had M3 response. Out of the 85 patients who did not have pancytopenia, 50 (58.8%) were male and 35 (41.2%) were female. Out of the 50 males withoutpancytopenia,36(72%) hadM1,10(20%)hadM2and4(8%) hadM3response.Among the 35 female patients, 31(88.57%) had M1, 2(5.71%) had M2 and 2(5.71%) had M3 response. Conclusion:The study concluded that although pancytopenia is a fairly common presentation of acute lymphoblastic leukemia but there is no significant difference in the outcome of patients receiving treatment for acute lymphoblastic leukemia in association with presence or absence of pancytopenia as initial presentation or with respect to duration of the disease.